SOUTH SHORE PHYSICAL THERAPY & SPORTSMEDICINE, INC (NPI# 1053617829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053617829 |
| Entity Type | Organization |
| Organization Name | SOUTH SHORE PHYSICAL THERAPY & SPORTSMEDICINE, INC |
| Other Organization Name | DBA IMUA PHYSICAL THERAPY |
| Practice Address |
380 Huku Lii Pl Ste 105 Kihei HI 96753-7043 |
| Practice Telephone | 8088790077 |
| Practice Fax Number | 8088790177 |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2012-09-11 |
| Authorized Official Name | MRS. TIFFANY G PRANGNELL (OWNER, PRESIDENT) |
| Authorized Official Telephone | 8088790077 |
| Authorized Official Credential | MPT, ATC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
1830 | HI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| DBA Imua Physical Therapy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760435218 | South Shore Physical Therapy & Sportsmedicine, Inc | Clinic/Center | 411 Huku Lii Pl Ste 101, Kihei, HI 96753 | 2006-05-18 |
| Street Address |
380 HUKU LII PL STE 105 |
| City | KIHEI |
| State | HI |
| Zip Code | 96753-7043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952820003 | Aaron Lee Crafton | Physical Therapy Assistant | 380 Huku Lii Pl Ste 105, Kihei, HI 96753-7043 | 2017-09-10 |
| 1033693148 | Heather Shennan Causey | Massage Therapist | 380 Huku Lii Pl Ste 105, Kihei, HI 96753-7043 | 2018-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490414 | Rheumatology Associates of Maui, LLC | Internal Medicine | 1444 S. Kihei Rd, Kihei, HI 96753 | 2020-09-01 |
| 1184259475 | Lindsey Therapy Services, LLC | Marriage & Family Therapist | 1847 South Kihei Rd., #205, Kihei, HI 96753 | 2020-03-06 |
| 1558922955 | Michaek Kalani Dacquel | Massage Therapist | 310 Ohukai Rd #312, Kihei, HI 96753 | 2019-06-26 |
| 1356830772 | Marc Kross Md Inc | Surgery | 30 E Lipoa St Unit 4108, Kihei, HI 96753 | 2018-05-02 |
| 1346793114 | Debra Bayer Inc | Substance Abuse Rehabilitation Facility | 1325 S Kihei Rd Ste 215, Kihei, HI 96753 | 2016-07-28 |
| 1912312364 | Lara Harvey | Marriage & Family Therapist | 1325 South Kihei Road, Suite 226b, Kihei, HI 96753 | 2014-06-24 |
| 1851735807 | Jeffrey Charles Olson | Dentist | 161 Wailea Ike Dr, Ste B104, Wailea, HI 96753 | 2013-04-22 |
| 1699016097 | Sky Lillian Sarah Connelly | Midwife | 484 Hoala Dr, Kihei, HI 96753 | 2013-03-09 |
| 1891031951 | Institute for Antiaging Studies | Clinic/Center | 214 Luakaha Cir, Kihei, HI 96753 | 2012-12-18 |
| 1790031433 | Zachary Hunter Rice | Acupuncturist | 344 Nehu Pl, Kihei, HI 96753 | 2012-07-31 |
| Find all providers in zip 96753 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982939807 | Therapeutic Fusion: Physical Therapy and Wellness,llc | Clinic/Center | 310 Ohukai Rd, Suite 310, Kihei, HI 96753-7061 | 2009-10-09 |
| 1891937231 | Kimura Physical Therapy | Clinic/Center | 535 Lipoa Pkwy Ste 151, Kihei, HI 96753-6902 | 2009-03-31 |
| 1760435218 | South Shore Physical Therapy & Sportsmedicine, Inc | Clinic/Center | 411 Huku Lii Pl Ste 101, Kihei, HI 96753 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265056154 | Molokai Physical Therapy & Rehabilitation LLC | Clinic/Center | 109 Ala Malama St Unit A, Kaunakakai, HI 96748 | 2020-06-05 |
| 1225659857 | Hana Pono Wellness Center LLC | Clinic/Center | 2 Aarona Pl Ste 202, Kailua, HI 96734-2545 | 2020-05-05 |
| 1881213767 | Avery Physical Therapy LLC | Clinic/Center | 45-167 Keana Rd, Kaneohe, HI 96744-2317 | 2020-04-10 |
| 1427681204 | Prime Pt Wellness Clinic | Clinic/Center | 45-955 Kamehameha Hwy Ste 300, Kaneohe, HI 96744-3292 | 2020-02-19 |
| 1154962660 | Park Physical Therapy, LLC | Clinic/Center | 850 W Hind Dr Ste 108, Honolulu, HI 96821-1845 | 2019-10-05 |
| 1497305833 | Christine Lynders Physical Therapy | Clinic/Center | 44-672 Kahinani Pl Apt 3, Kaneohe, HI 96744-2500 | 2019-09-18 |
| 1548819790 | Live Pain Free Pt | Clinic/Center | 55 S Judd St Apt 808, Honolulu, HI 96817-2608 | 2019-09-10 |
| 1093278830 | Ronald Y Hanagami P T LLC | Clinic/Center | 99-862 Aiea Heights Dr, Aiea, HI 96701-3503 | 2019-04-09 |
| 1609332972 | Mauka Movement LLC | Clinic/Center | 81-965 Halekii St Ste C, Kealakekua, HI 96750-8164 | 2019-02-12 |
| 1922582865 | Komd Hawaii LLC | Clinic/Center | 55 S Judd St Apt 1004, Honolulu, HI 96817-2610 | 2018-09-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.