Active NPI
Brannt Ibara
- Registered Nurse
- Kapolei, HI
National Provider Identifier
1790508562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN-114421-0
- Practice address
- 91-1078 Yorktown St
Kapolei, HI 96707-2160 - Phone
- (808) 433-0645
- NPI assigned
- Oct 31, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN-114421-0 | HI | Primary |
Addresses
Primary practice location
91-1078 Yorktown St
Kapolei, HI 96707-2160
Mailing address
95-1081 Keni St
Mililani, HI 96789-6550
Phone (808) 753-6710
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 |
|---|---|---|---|
| RN-114421-0 | HI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1790508562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95-1081 KENI ST",
"city": "MILILANI",
"state": "HI",
"postal_code": "967896550",
"telephone_number": "808-753-6710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91-1078 YORKTOWN ST",
"city": "KAPOLEI",
"state": "HI",
"postal_code": "967072160",
"telephone_number": "808-433-0645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBARA",
"first_name": "BRANNT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-31",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "HI",
"license": "RN-114421-0",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kapolei, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.