Active NPI
Carly M Watanabe
- Physical Therapist
- Kailua, HI
National Provider Identifier
1912299264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT3327
- Practice address
- 407 Uluniu St
#301
Kailua, HI 96734-2519 - Phone
- (808) 261-4321
- Fax
- (808) 261-4320
- NPI assigned
- May 4, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT3327 | HI | Primary |
Addresses
Primary practice location
407 Uluniu St
#301
Kailua, HI 96734-2519
Mailing address
407 Uluniu St
#301
Kailua, HI 96734-2519
Phone (808) 261-4321
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT3327 | HI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373846400000",
"number": "1912299264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 ULUNIU ST",
"address_2": "#301",
"city": "KAILUA",
"state": "HI",
"postal_code": "967342519",
"telephone_number": "808-261-4321",
"fax_number": "808-261-4320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 ULUNIU ST",
"address_2": "#301",
"city": "KAILUA",
"state": "HI",
"postal_code": "967342519",
"telephone_number": "808-261-4321",
"fax_number": "808-261-4320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATANABE",
"first_name": "CARLY",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-04",
"last_updated": "2013-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "PT3327",
"primary": true
}
],
"identifiers": [],
"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 Jul 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.