Waves of Health LLC

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

License

MD-15206 Issued in HI

Legal business name

WAVES OF HEALTH LLC

Doing business as

BoardsportsDoc

Practice address

68-615 Farrington Hwy
21A
Waialua, HI 96791-9377

Phone

(303) 882-7739

NPI assigned

Apr 8, 2010

Last updated

Dec 22, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Clayton Austin Everline, M.D.

Title

Physician

Phone

(303) 882-7739

Specialties & licenses 1

Addresses

Other names 1

• BoardsportsDoc Doing business as

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1871819318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68-615 FARRINGTON HWY",
            "address_2": "21A",
            "city": "WAIALUA",
            "state": "HI",
            "postal_code": "967919377",
            "telephone_number": "303-882-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68-615 FARRINGTON HWY",
            "address_2": "21A",
            "city": "WAIALUA",
            "state": "HI",
            "postal_code": "967919377",
            "telephone_number": "303-882-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVES OF HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "EVERLINE",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "303-882-7739",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "HI",
            "license": "MD-15206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BoardsportsDoc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaualiiliimaikalani Mayumi Segawa, ATC
• Nina Summers, MT
• The Wahiawa Center for Community Health
• Therapy on the Go, Inc.
• Myron James Vititow, LMT

• Sports Medicine (Internal Medicine) Physician in Waialua, HI
• Providers in Waialua, HI by specialty
• Sports Medicine (Internal Medicine) Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.