Iasis Spinal Treatment Center, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1497 Issued in HI

Legal business name

IASIS SPINAL TREATMENT CENTER, LLC

Practice address

4747 Kilauea Ave
#201
Honolulu, HI 96816-5308

Phone

(808) 542-4029

Fax

(808) 739-2828

NPI assigned

Jan 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Eric Seiyo Kamimura, P.T.

Title

Member

Phone

(808) 542-4029

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780737759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-502 APIKI ST",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967441918",
            "telephone_number": "808-542-4029",
            "fax_number": "808-739-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 KILAUEA AVE",
            "address_2": "#201",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165308",
            "telephone_number": "808-542-4029",
            "fax_number": "808-739-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IASIS SPINAL TREATMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAMIMURA",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "SEIYO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "808-542-4029",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "1497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA INSURANCE PROVIDER #",
            "identifier": "0000257527",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Honolulu, HI
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.