Ricky Desi Bautista, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC420 Issued in HI

Practice address

45-270 William Henry Rd
Ste 205
Kaneohe, HI 96744-5808

Phone

(808) 235-6677

Fax

(808) 236-0844

NPI assigned

Sep 5, 2007

Last updated

Feb 21, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: ricky.bautista@16504189222916.direct.elationemr.com

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1962696658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-270 WILLIAM HENRY RD",
            "address_2": "STE 205",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967445808",
            "telephone_number": "808-235-6677",
            "fax_number": "808-236-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45-270 WILLIAM HENRY RD",
            "address_2": "STE 205",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967445808",
            "telephone_number": "808-235-6677",
            "fax_number": "808-236-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "RICKY",
        "middle_name": "DESI",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "DC420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "F0098993",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Kaneohe, HI
• Providers in Kaneohe, HI by specialty
• Chiropractor in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.