Ezra Imipono Sheridan

Primary specialty

Rehabilitation CounselorTaxonomy code 225C00000X

Practice address

56-660 Kamehameha Hwy
Kahuku, HI 96731-2210

Phone

(877) 393-7555

NPI assigned

Apr 4, 2025

Last updated

Apr 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1743724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1891589016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59-448 KAMEHAMEHA HWY",
            "city": "HALEIWA",
            "state": "HI",
            "postal_code": "967129624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56-660 KAMEHAMEHA HWY",
            "city": "KAHUKU",
            "state": "HI",
            "postal_code": "967312210",
            "telephone_number": "877-393-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "EZRA",
        "middle_name": "IMIPONO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-04",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merita Sao-Auelua, REGISTERED NURSE
• Cheyenne Schoenfeld
• Sierra Semenchuk
• Josiah Seui
• Bridget Diane Shelley
• Doris Sila, CMA
• Jeff D. Smith, MD
• Sara Nelson Smith
• Pato Sina Soli
• Thomas Sperandeo, M.D.

• Rehabilitation Counselor in Kahuku, HI
• Providers in Kahuku, HI by specialty
• Rehabilitation Counselor in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; 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.