Individual provider Active NPI

Eydie Hanami Shimote Nakasone, M.A., OTR

  • Pediatric Occupational Therapist
  • Honolulu, HI
National Provider Identifier
1760517445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT-382 Issued in HI
Practice address
1319 Punahou St
Honolulu, HI 96826-1001
Phone
(808) 983-6742
Fax
(808) 983-6752
NPI assigned
Feb 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT-382 HI Primary

Addresses

Primary practice location

1319 Punahou St
Honolulu, HI 96826-1001

Mailing address

95-2063 Puukaa St
Mililani, HI 96789-6510
Phone (808) 983-6742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
OT-382HIMDPediatric Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760517445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-2063 PUUKAA ST",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967896510",
            "telephone_number": "808-983-6742",
            "fax_number": "808-983-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 PUNAHOU ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968261001",
            "telephone_number": "808-983-6742",
            "fax_number": "808-983-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKASONE",
        "first_name": "EYDIE",
        "middle_name": "HANAMI SHIMOTE",
        "name_prefix": "Mrs.",
        "credential": "M.A., OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "HI",
            "license": "OT-382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.