Individual provider Active NPI

Maricel Ballares

  • Foster Care Agency
  • Waipahu, HI
National Provider Identifier
1780084681
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
HCBS 09-2434 Issued in HI
Practice address
94-877 Lumiiki St
Waipahu, HI 96797-3933
Phone
(808) 729-3216
Fax
(808) 200-5552
NPI assigned
Aug 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X HCBS 09-2434 HI Primary

Addresses

Primary practice location

94-877 Lumiiki St
Waipahu, HI 96797-3933

Mailing address

94-877 Lumiiki St
Waipahu, HI 96797-3933
Phone (808) 729-3216

Other names 1

  • N/a N/a N/a Former name

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

State licenses

LicenseStateTypeSpecialty
HCBS 09-2434HIMDFoster Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1780084681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-877 LUMIIKI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973933",
            "telephone_number": "808-729-3216",
            "fax_number": "808-200-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-877 LUMIIKI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973933",
            "telephone_number": "808-729-3216",
            "fax_number": "808-200-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARES",
        "first_name": "MARICEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "HI",
            "license": "HCBS 09-2434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "middle_name": "N/A",
            "credential": "PROVIDER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.