Stephanie Ann Dodge, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY1318 Issued in HI

Practice address

688 Kinoole St
Hilo, HI 96720-3877

Phone

(808) 747-3445

Fax

(808) 443-5196

NPI assigned

May 15, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kohala Coast Urgent Care LLCGroup PAC ID 1759751019, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.dodge@hawaiihie.medicity.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kohala Coast Urgent Care LLC

  • Urgent Care Clinic/Center
  • Kamuela, HI
  • NPI 1881328441
  Medicare reassignment Care Compare group NPD
• Amanda Webster Wellness

  • Mental Health Counselor
  • Hilo, HI
  • NPI 1306689740
  NPD (past)

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1942569629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11339",
            "city": "HILO",
            "state": "HI",
            "postal_code": "96721",
            "telephone_number": "808-747-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 KINOOLE ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967203877",
            "telephone_number": "808-747-3445",
            "fax_number": "808-443-5196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28-255 Stable Camp Rd",
            "address_purpose": "LOCATION",
            "city": "Honom",
            "state": "HI",
            "postal_code": "96728",
            "country_code": "US",
            "telephone_number": "808-747-3445",
            "fax_number": "808-443-5196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODGE",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-15",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY1318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "I DON'T HAVE ANOTHER IDENTIFICATION NUMBER",
            "identifier": "000000000000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul R Divinski, LCSW
• Carol Dixon, MSN
• Djon Indra Lim, M.D. Facp, Inc.
• DLMC, Inc.
• Douglas Dung DO, M.D, M.P.H
• Julia Doi
• Lynda M. Dolan, M.D.
• Brooklyn Domen
• Lauren Domingo, PHARMD
• Don T. Matsuura, M.D., Inc.

• Psychologist in Hilo, HI
• Providers in Hilo, HI by specialty
• Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.