Poipu MD, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

14727 Issued in HI

Legal business name

POIPU MD, LLC

Doing business as

Poipu Mobile MD

Practice address

5485 Koloa Rd
Suite 1652
Koloa, HI 96756-3001

Phone

(808) 346-3324

NPI assigned

Sep 21, 2015

Last updated

Jun 4, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

POIPU MD, LLCAs reported in NPPES

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

Authorized official

Name

Dr. J Burris Jr., MD, MPH

Title

President

Phone

(808) 652-7021

Specialties & licenses 1

Addresses

Other names 1

• Poipu Mobile MD Doing business as

Part of

Poipu MD LLC

Locations

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464998400000",
    "number": "1821467796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1652",
            "city": "KOLOA",
            "state": "HI",
            "postal_code": "967561652",
            "telephone_number": "808-346-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5485 KOLOA RD",
            "address_2": "SUITE 1652",
            "city": "KOLOA",
            "state": "HI",
            "postal_code": "967563001",
            "telephone_number": "808-346-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POIPU MD, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POIPU MD, LLC",
        "enumeration_date": "2015-09-21",
        "last_updated": "2016-06-04",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-652-7021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "HI",
            "license": "14727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poipu Mobile MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hugh Scott Moore, MD
• Joseph M. Murray, M.D.
• Nerveflow (Dillberg Integrated Healthcare)
• Jeanette Nguyen, APRN
• Holly Marie Poag, D.O.
• Puuwai Professional Enterprises, LLC (Poipu Urgent Care)
• Shalyn R Rosek, LCSW
• Scott K Ross, MD
• Samuel Mahelona Memorial Hospital (HHSC - Kauai Region Clinics Urgent Care at Poipu)
• Jordan Sleeth, LCSW

• Urgent Care Clinic/Center in Koloa, HI
• Providers in Koloa, HI by specialty
• Urgent Care Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2016; 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.