NPIMap

Organization Active NPI

Skin Kahala LLC

Doing business as Wound Care Hawaii

  • Family Medicine Physician
  • Honolulu, HI
National Provider Identifier
1881437168
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SKIN KAHALA LLC
Doing business as
Wound Care Hawaii
Practice address
4819 Kilauea Ave Ste 7
Honolulu, HI 96816-5712
Phone
(310) 709-5492
Fax
(808) 808-1324
NPI assigned
Jun 14, 2024
Last updated
Sep 30, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SKIN KAHALA LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
Taryn Wright
Title
Practice Manager
Phone
(808) 808-1324

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

4819 Kilauea Ave Ste 7
Honolulu, HI 96816-5712

Mailing address

4819 Kilauea Ave Ste 7
Honolulu, HI 96816-5712
Phone (310) 709-5492

Other names 1

  • Wound Care Hawaii Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240803000497 HI Part B Supplier - Clinic/Group Practice 5698212934 Receives reassigned benefits from 8 practitioners
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory
Part of
Skin Kahala LLC

Practitioners & affiliated clinicians

Practitioners 11

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": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1881437168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4819 KILAUEA AVE STE 7",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165712",
            "telephone_number": "310-709-5492",
            "fax_number": "808-808-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4819 KILAUEA AVE STE 7",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968165712",
            "telephone_number": "310-709-5492",
            "fax_number": "808-808-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN KAHALA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SKIN KAHALA LLC",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "TARYN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "808-808-1324"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wound Care Hawaii",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.