Active NPI
Brenda Yvonne Wong, RPT
- Physical Therapist
- Wailuku, HI
National Provider Identifier
1801071626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1538
- Practice address
- 911 Wailupe Dr
Wailuku, HI 96793-9659 - Phone
- (808) 276-4226
- Fax
- (808) 986-8241
- NPI assigned
- Dec 31, 2007
- Last updated
- Dec 31, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1538 | HI | Primary |
Addresses
Primary practice location
911 Wailupe Dr
Wailuku, HI 96793-9659
Mailing address
911 Wailupe Dr
Wailuku, HI 96793-9659
Phone (808) 276-4226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 549454 | Medicaid | HI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1538 | HI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199059200000",
"number": "1801071626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 WAILUPE DR",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967939659",
"telephone_number": "808-276-4226",
"fax_number": "808-986-8241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 WAILUPE DR",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967939659",
"telephone_number": "808-276-4226",
"fax_number": "808-986-8241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "BRENDA",
"middle_name": "YVONNE",
"name_prefix": "Mrs.",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-31",
"last_updated": "2007-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "1538",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "549454",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wailuku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.