Jacy C Cabael-Tellis

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

2500 Campus Rd
Honolulu, HI 96822-2217

Phone

(808) 956-8111

NPI assigned

Apr 17, 2021

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

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": "1618617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618617600000",
    "number": "1780265140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2069 CALIFORNIA AVE APT 14H",
            "city": "WAHIAWA",
            "state": "HI",
            "postal_code": "967862779",
            "telephone_number": "808-386-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 CAMPUS RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968222217",
            "telephone_number": "808-956-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABAEL-TELLIS",
        "first_name": "JACY",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-17",
        "last_updated": "2021-04-17",
        "certification_date": "2021-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Athletic Trainer in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2021; 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.