Individual provider Active NPI

Rowena Raymundo Agustin

  • Licensed Practical Nurse
  • Aiea, HI
National Provider Identifier
1922768019
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN-19762 Issued in HI
Practice address
98-241 Hale Momi PL
Aiea, HI 96701-4411
Phone
(808) 230-5465
Fax
(808) 200-7834
NPI assigned
Dec 30, 2021
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN-19762 HI Primary

Addresses

Primary practice location

98-241 Hale Momi PL
Aiea, HI 96701-4411

Mailing address

98-241 Hale Momi PL
Aiea, HI 96701-4411
Phone (808) 230-5465

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

State licenses

LicenseStateTypeSpecialty
LPN-19762HIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1922768019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-241 HALE MOMI PL",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014411",
            "telephone_number": "808-230-5465",
            "fax_number": "808-200-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-241 HALE MOMI PL",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014411",
            "telephone_number": "808-230-5465",
            "fax_number": "808-200-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTIN",
        "first_name": "ROWENA",
        "middle_name": "RAYMUNDO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "HI",
            "license": "LPN-19762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.