NPIMap

Organization Active NPI

West Hawaii Community Health Center, Inc.

Doing business as Hawaii Island Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Kealakekua, HI
National Provider Identifier
1912763236
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WEST HAWAII COMMUNITY HEALTH CENTER, INC.
Doing business as
Hawaii Island Community Health Center
Practice address
81-1043 Konawaena School Rd
Kealakekua, HI 96750-8121
Phone
(808) 326-5629
NPI assigned
Feb 23, 2024
Last updated
Feb 23, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST HAWAII COMMUNITY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Authorized official

Name
Richard J Taaffe
Title
Chief Executive Officer
Phone
(808) 326-3884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

81-1043 Konawaena School Rd
Kealakekua, HI 96750-8121

Mailing address

75-5751 Kuakini Hwy Ste 203
Kailua Kona, HI 96740-1753
Phone (808) 756-2927

Other names 2

  • Hawaii Island Community Health Center Doing business as
  • Konawaena High School Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240909003867 HI Part A Provider - Federally Qualified Health Center (FQHC) 1557389400 Practice locations: Kealakekua, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912763236. Details of each certification follow.

Federally qualified health center certification: CCN 121020

Legal name
WEST HAWAII COMMUNITY HEALTH CENTER INC
Doing business as
HAWAII ISLAND COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 5, 2024
Last certification
Sep 5, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 2003 in HI
Enrollment address
81-1043 Konawaena School Rd
Kealakekua, HI 96750-8121

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

National Provider Directory

National Provider Directory
Tax ID family
West Hawaii Community Health Center Inc19 organizations share this tax ID, including this one
Part of
West Hawaii Community Health Center Inc

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

81-1043 Konawaena School Rd
Kealakekua, HI 96750
Phone (808) 323-4500

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marlo Lyman-Kekaualua Individual Corporate DirectorBoard Member Jul 1, 2022
Richard J Taaffe Individual Corporate OfficerCeo Oct 31, 2005
W-2 Managing EmployeeCeo Oct 31, 2005
Brandee Menino Individual Corporate DirectorBoard Member Jul 1, 2022
Patti Aoki Individual Corporate DirectorBoard Member Mar 24, 2022
Britta Zimmer Individual Corporate DirectorBoard Member Jul 1, 2022
Peter Hoffmann Individual Corporate DirectorBoard Member Mar 24, 2022
Tom Hasslinger Individual Corporate DirectorBoard Member Mar 24, 2022
Adam Keith Bauer Individual Corporate OfficerBoard Treasurer Jul 1, 2022
Corporate DirectorBoard Member Jul 1, 2022
Michael Matsukawa Individual Corporate OfficerBoard Chair Mar 24, 2022
Corporate DirectorBoard Member Mar 24, 2022
Elisa Yadao Individual Corporate DirectorBoard Member Mar 24, 2022
Haidee O Abe Individual Corporate OfficerBoard Vice Chair Jul 1, 2022
Corporate DirectorBoard Member Jul 1, 2022
Victoria K Hanes Individual Corporate OfficerCoo May 26, 2020
W-2 Managing EmployeeCoo May 26, 2020
Diane Pautz Individual Corporate OfficerCfo Jul 28, 2008
W-2 Managing EmployeeCfo Jul 28, 2008
Katharyn Daub Individual Corporate DirectorBoard Member Jul 1, 2022
Michael McGee Individual Corporate DirectorBoard Member Jul 1, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1912763236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY STE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401753",
            "telephone_number": "808-756-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81-1043 KONAWAENA SCHOOL RD",
            "city": "KEALAKEKUA",
            "state": "HI",
            "postal_code": "967508121",
            "telephone_number": "808-326-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST HAWAII COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST HAWAII COMMUNITY HEALTH CENTER, INC.",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "TAAFFE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-326-3884"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hawaii Island Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Konawaena High School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kealakekua, HI

Sources for this page

Verify at the official NPI Registry.