Individual provider Active NPI

Jessica Stare Valant, MSPT

  • Physical Therapist
  • Kailua, HI
National Provider Identifier
1891820247
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2677 Issued in HI
Practice address
602 Kailua Rd
#202
Kailua, HI 96734-2841
Phone
(808) 277-7641
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2677 HI Primary

Addresses

Primary practice location

602 Kailua Rd
#202
Kailua, HI 96734-2841

Mailing address

602 Kailua Rd
#202
Kailua, HI 96734-2841
Phone (808) 277-7641

Other identifiers 2

IdentifierTypeStateIssuer
59164501MedicaidHI
0000267864OtherHIHMSA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42281CAMDDentist
7471COMDGeneral Practice Dentistry
2677HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Windward Rehabilitation Services, LLC Physical Therapist Past Accepting new patients
Performax Front Range Physical Therapy LLC Physical Therapist Past Accepting new patients
Joseph J Teixeira RPT PC Physical Therapist PastSince May 1, 2002 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1891820247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 KAILUA RD",
            "address_2": "#202",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342841",
            "telephone_number": "808-277-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 KAILUA RD",
            "address_2": "#202",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342841",
            "telephone_number": "808-277-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALANT",
        "first_name": "JESSICA",
        "middle_name": "STARE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59164501",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000267864",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.