Aloha Pain Sports & Spine Medicine LLC
Organization Active NPI Pain Medicine (Physical Medicine & Rehabilitation) Physician · Kailua, HI
NPI 1841522471 · NPPES record last updated Jun 7, 2010
Key facts
- NPI
- 1841522471
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X
- License
- DOS1153 (HI)
- Legal business name
- ALOHA PAIN SPORTS & SPINE MEDICINE LLC
- Practice address
- 407 Uluniu St
Suite 201
Kailua, HI 96734-2519 - Phone
- (808) 261-7246
- Fax
- (808) 261-7248
- NPI assigned
- Feb 7, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Kerrey L. Barton Taylor, DO
- Title
- Vice-President
- Phone
- (808) 261-7246
Practitioners 3
-
Kerrey Lin Barton Taylor, D.O.
-
Robert Vit Jao, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 12D2020639 | Aloha Pain Sports and Spine Medicine LLC | Certificate of waiver | Feb 23, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100518000163 | HI | Part B Supplier - Clinic/Group Practice | 7012045792 |
Receives reassigned benefits from 2 practitioners Practice locations: Kailua, HI |
National Provider Directory
Locations
407 Uluniu St
Ste 201
Kailua, HI 96734
Phone (808) 261-7246
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Physical Medicine & Rehabilitation) Physician |
2081P2900X | DOS1153 | HI | Yes |
| Sports Medicine (Physical Medicine & Rehabilitation) Physician |
2081S0010X | MD14322 | HI |
Addresses
Primary practice location
407 Uluniu St
Suite 201
Kailua, HI 96734-2519
Mailing address
407 Uluniu St
Suite 201
Kailua, HI 96734-2519
Phone (808) 261-7246
Other providers in Kailua, HI
- Allied Nutrition Works LLC
- Austin Allwein
- Aloha Behavioral Practice
- Aloha Foot Centers, Inc.
- Aloha Mobile Phlebotomy LLC
- Aloha Within
- Stacey Joy Alonzo
- Christal Ceferina Amado-Saranillio
- Amazing Behaving LLC
- Amh Series II, Hi, LLC
All providers in Kailua, HI · Pain Medicine (Physical Medicine & Rehabilitation) Physician in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.