NPIMap

Organization Active NPI

Jennifer Grune DNP FNP-BC

Doing business as Park Wellness

  • Primary Care Clinic/Center
  • Kea'au, HI
National Provider Identifier
1861994626
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
JENNIFER GRUNE DNP FNP-BC
Doing business as
Park Wellness
Practice address
16-590 Old Volcano Rd Ste B
Keaau, HI 96749-8158
Phone
(808) 333-3450
Fax
(808) 930-4721
NPI assigned
Mar 7, 2018
Last updated
Sep 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Authorized official

Name
Dr. Jennifer Grune, APRNNPI 1720599640
Title
Ceo/Aprn
Phone
(808) 333-3450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APRN-2244 HI

Addresses

Primary practice location

16-590 Old Volcano Rd Ste B
Keaau, HI 96749-8158

Mailing address

16-590 Old Volcano Rd Ste B
Keaau, HI 96749-8158
Phone (808) 333-3450

Other names 1

  • Park Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180410001032 HI Part B Supplier - Clinic/Group Practice 5294098042 Receives reassigned benefits from 2 practitioners
Practice locations: Keaau, HI

National Provider Directory

National Provider Directory

Locations

16-566 Keaau Pahoa Rd
Keaau, HI 96749
Phone (808) 294-3022

16-590 Old Volcano Rd
Ste Bc
Keaau, HI 96749
Phone (808) 333-3450

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1861994626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16-590 OLD VOLCANO RD STE B",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498158",
            "telephone_number": "808-333-3450",
            "fax_number": "808-930-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-590 OLD VOLCANO RD STE B",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498158",
            "telephone_number": "808-333-3450",
            "fax_number": "808-930-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER GRUNE DNP FNP-BC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-07",
        "last_updated": "2024-09-04",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "GRUNE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO/APRN",
        "authorized_official_telephone_number": "808-333-3450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-2244",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kea'au, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.