Active NPI
Brooke Nicole Johnson, OT
- Occupational Therapist
- Hilo, HI
National Provider Identifier
1962905620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1658
- Practice address
- 944 W Kawailani St
Hilo, HI 96720-3218 - Phone
- (808) 959-9151
- Fax
- (808) 930-9167
- NPI assigned
- Mar 8, 2018
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1658 | HI | Primary |
Addresses
Primary practice location
944 W Kawailani St
Hilo, HI 96720-3218
Mailing address
944 W Kawailani St
Hilo, HI 96720-3218
Phone (808) 930-9158
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1658 | HI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520467200000",
"number": "1962905620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "944 W KAWAILANI ST",
"city": "HILO",
"state": "HI",
"postal_code": "967203218",
"telephone_number": "808-930-9158",
"fax_number": "808-930-9167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "944 W KAWAILANI ST",
"city": "HILO",
"state": "HI",
"postal_code": "967203218",
"telephone_number": "808-959-9151",
"fax_number": "808-930-9167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BROOKE",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-08",
"last_updated": "2018-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "HI",
"license": "1658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hilo, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.