Active NPI
Lystra Irene Braumuller, RN
- Case Manager/Care Coordinator
- Pearl Harbor, HI
National Provider Identifier
1902380413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 35612
- Practice address
- 480 Central Ave
Pearl Harbor, HI 96860-4908 - Phone
- (808) 471-1866
- Fax
- (808) 471-7855
- NPI assigned
- Sep 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 35612 | HI | Primary |
Addresses
Primary practice location
480 Central Ave
Pearl Harbor, HI 96860-4908
Mailing address
Potomac Healthcare Solutions
1549 Old Bridge Road Suite 201
Woodbridge, VA 22191
Phone (703) 496-5321
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35612 | HI | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537401600000",
"number": "1902380413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "POTOMAC HEALTHCARE SOLUTIONS",
"address_2": "1549 OLD BRIDGE ROAD SUITE 201",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "22191",
"telephone_number": "703-496-5321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 CENTRAL AVE",
"city": "PEARL HARBOR",
"state": "HI",
"postal_code": "968604908",
"telephone_number": "808-471-1866",
"fax_number": "808-471-7855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAUMULLER",
"first_name": "LYSTRA",
"middle_name": "IRENE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-20",
"last_updated": "2018-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "HI",
"license": "35612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearl Harbor, HI
- Danielle M Braiotta, RN
- Branch Medical Clinic Annex Wahiawa
- Branch Medical Clinic Camp Smith Medical Annex
- Branch Medical Clinic Kaneohe
- Branch Medical Clinic Naval Shipyard Pearl Harbor
- Amy Brender, RN
- Susan Lynn Brennan, R.D.H.
- Melissa Mihwa Bridgett, RN
- Nicholas Bronowski, PT, OCS
- Eleanor Awen Bru
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.