NPIMap

Organization Active NPI

Elam Sports, Inc.

Doing business as Elam Sports Oahu

  • Physical Therapist
  • Pearl City, HI
National Provider Identifier
1770512048
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ELAM SPORTS, INC.
Doing business as
Elam Sports Oahu
Practice address
425 Kamehameha Hwy
Suite 2B
Pearl City, HI 96782-3238
Phone
(808) 674-9595
Fax
(808) 674-9696
NPI assigned
Jun 30, 2006
Last updated
Nov 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Authorized official

Name
Chandra L Elam
Title
Company Officer
Phone
(808) 674-9595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

425 Kamehameha Hwy
Suite 2B
Pearl City, HI 96782-3238

Mailing address

1001 Kamokila Blvd
Suite 111 JCB
Kapolei, HI 96707-2014
Phone (808) 674-9595

Other identifiers 2

IdentifierTypeStateIssuer
50320201MedicaidHI
A218931OtherHIHMSA

Other names 1

  • Elam Sports Oahu Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000065 HI Part B Supplier - Clinic/Group Practice 7618880535 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kapolei, HI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 80

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 80

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1770512048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 KAMOKILA BLVD",
            "address_2": "SUITE 111 JCB",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072014",
            "telephone_number": "808-674-9595",
            "fax_number": "808-674-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 KAMEHAMEHA HWY",
            "address_2": "SUITE 2B",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967823238",
            "telephone_number": "808-674-9595",
            "fax_number": "808-674-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELAM SPORTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "ELAM",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "COMPANY OFFICER",
        "authorized_official_telephone_number": "808-674-9595"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50320201",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "A218931",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elam Sports Oahu",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pearl City, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.