David S Jordan

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

4 1751 Kuhio Highway
Friendship House Psycho Social Rehabilitation Progarm
Kapaa, HI 96746-2064

Phone

(808) 821-4480

Fax

(808) 821-4483

NPI assigned

Feb 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760519086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 3212 KUHIO HIGHWAY",
            "address_2": "KAUAI COMMUNITY MENTAL HEALTH CENTER",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661142",
            "telephone_number": "808-274-3190",
            "fax_number": "808-274-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 1751 KUHIO HIGHWAY",
            "address_2": "FRIENDSHIP HOUSE PSYCHO SOCIAL REHABILITATION PROGARM",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967462064",
            "telephone_number": "808-821-4480",
            "fax_number": "808-821-4483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "DAVID",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53937202",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Kapaa, HI
• Providers in Kapaa, HI by specialty
• Social Worker in Hawaii

• 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.