NPIMap

Organization Active NPI

Emergency Medical Care

  • Emergency Medicine Physician
  • Honolulu, HI
National Provider Identifier
1902085863
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY MEDICAL CARE
Practice address
2230 Liliha St
Honolulu, HI 96817-1646
Phone
(808) 547-6387
Fax
(808) 595-6189
NPI assigned
Oct 29, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Jennifer Provasnik
Title
Supervisor of Provider Enrollment
Phone
(800) 355-0808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X HI Primary

Addresses

Primary practice location

2230 Liliha St
Honolulu, HI 96817-1646

Mailing address

PO Box 8490
Philadelphia, PA 19101-8490
Phone (800) 355-0808

Other identifiers 1

IdentifierTypeStateIssuer
009448MedicaidHI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1902085863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8490",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191018490",
            "telephone_number": "800-355-0808",
            "fax_number": "215-834-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 LILIHA ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968171646",
            "telephone_number": "808-547-6387",
            "fax_number": "808-595-6189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "PROVASNIK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SUPERVISOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "800-355-0808"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009448",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 20, 2008; 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.