Active NPI
Glenda Shy
- Massage Therapist
- Waipahu, HI
National Provider Identifier
1780113993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAT-11713
- Practice address
- 94-689 Farrington Hwy
Waipahu, HI 96797-3015 - Phone
- (808) 676-7700
- Fax
- (808) 676-7708
- NPI assigned
- Jun 9, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA-141 | HI | |
| Massage Therapist | 225700000X | MAT-11713 | HI | Primary |
Addresses
Primary practice location
94-689 Farrington Hwy
Waipahu, HI 96797-3015
Mailing address
94-689 Farrington Hwy
Waipahu, HI 96797-3015
Phone (808) 676-7700
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA-141 | HI | MD | Physical Therapy Assistant |
| MAT-11713 | HI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waipahu Physical Therapy, Inc | Multi-Specialty | Current | Accepting new patients |
| Elam Sports, Inc | Multi-Specialty | Past | Accepting new patients |
| Wahiawa Rehab Services Inc | Multi-Specialty | Past | Accepting new patients |
Locations
94-689 Farrington Hwy
Waipahu, HI 96797
Phone (808) 618-6878
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1780113993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-689 FARRINGTON HWY",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967973015",
"telephone_number": "808-676-7700",
"fax_number": "808-676-7708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-689 FARRINGTON HWY",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967973015",
"telephone_number": "808-676-7700",
"fax_number": "808-676-7708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHY",
"first_name": "GLENDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-09",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "HI",
"license": "PTA-141",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "HI",
"license": "MAT-11713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.