LIBERTY DIALYSIS - HAWAII LLC (NPI# 1134160187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134160187 |
| Entity Type | Organization |
| Organization Name | LIBERTY DIALYSIS - HAWAII LLC |
| Other Organization Name | LIBERTY DIALYSIS HAWAII - KONA DIALYSIS FACILITY |
| Practice Address |
78-6831 Alii Dr Suite 336 Kailua Kona HI 96740-2495 |
| Mailing Address |
7650 Se 27th St Suite 200 Mercer Island WA 98040-3060 |
| Practice Telephone | 8083222131 |
| Mailing Telephone | 2062365001 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | RYAN B PARDO (VICE PRESIDENT) |
| Authorized Official Telephone | 2062365001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | 00J0257467 | 05 |
| Other Name | Type Code |
|---|---|
| Liberty Dialysis Hawaii - Kona Dialysis Facility | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447872395 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 2226 Liliha St Fl 2, Honolulu, HI 96817-1600 | 2020-05-14 |
| 1467971465 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 500 Ala Moana Blvd Ste 7302, Honolulu, HI 96813 | 2017-09-12 |
| 1073060638 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 4380 Lumehana Street, Honolulu, HI 96818-3137 | 2016-09-01 |
| 1164684825 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 94-450 Mokuola St, Waipahu, HI 96797-3300 | 2008-06-25 |
| 1003931494 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 3625 Harding Ave, Honolulu, HI 96816-3701 | 2007-03-21 |
| 1932140811 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 105 Maui Lani Parkway, Suite 105, Wailuku, HI 96793-2528 | 2006-06-09 |
| 1487810933 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 25 Kaneohe Bay Dr, Suite 230, Kailua, HI 96734-1711 | 2008-08-04 |
| Street Address |
78-6831 ALII DR SUITE 336 |
| City | KAILUA KONA |
| State | HI |
| Zip Code | 96740-2495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730744640 | Jaime Angelyn Westlund | Registered Nurse | 78-6831 Alii Dr, Kailua Kona, HI 96740-2495 | 2019-05-06 |
| 1396237855 | Katelyn Mary Lapak | Physical Therapist | 78-6831 Alii Dr, Kailua Kona, HI 96740-2495 | 2018-05-31 |
| 1902340722 | Jaime Granchelli | Physical Therapist | 78-6831 Alii Dr, Kailua Kona, HI 96740-2495 | 2016-12-13 |
| 1972927119 | Therapydia, Inc. | Clinic/Center | 78-6831 Alii Dr, #420, Kailua Kona, HI 96740-2495 | 2014-02-07 |
| 1548693518 | Tyler J Patrick | Physical Therapist | 78-6831 Alii Dr, #420, Kailua Kona, HI 96740-2495 | 2013-08-14 |
| 1003016171 | Longs Drug Stores California Inc. | Durable Medical Equipment & Medical Supplies | 78-6831 Alii Dr, Ste H, Kailua Kona, HI 96740-2495 | 2007-07-18 |
| 1497801773 | Peggy J Basinga | Pharmacy Technician | 78-6831 Alii Dr, Kailua Kona, HI 96740-2495 | 2007-01-26 |
| 1902956360 | Puna Plantation Hawaii, Ltd. | Durable Medical Equipment & Medical Supplies | 78-6831 Alii Dr, Kailua Kona, HI 96740-2495 | 2007-01-10 |
| 1518057017 | Puna Plantation Hawaii, Ltd. | Pharmacy | 78-6831 Alii Dr, Kailua Kona, HI 96740-2495 | 2006-10-13 |
| 1679598759 | Harnath Christopher Holmes | Obstetrics & Gynecology | 78-6831 Alii Dr, Suite 422, Kailua Kona, HI 96740-2495 | 2006-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870577 | Elise Christine Duvua | Massage Therapist | 75-127 Lunadule Rd. Suite #5, Kailua Kona, HI 96740 | 2020-10-29 |
| 1356954820 | Zellda Keath | Acupuncturist | Kohanaiki Club Services, 73-2055 Ala Kohanaiki, Kailua-kona, HI 96740 | 2020-08-25 |
| 1467070979 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 75-971 Henry St, Kailua Kona, HI 96740 | 2020-07-10 |
| 1275182040 | Jessica Marie Penaranda | Pharmacist | 5595 Palani Road, Kona, HI 96740 | 2019-09-05 |
| 1558870600 | Malia Lewis Vannatta | Nurse Practitioner | 75-184 Hulalalai Rd, 302, Kailua Kona, HI 96740 | 2017-09-20 |
| 1043759087 | Paul Michael Heller | Acupuncturist | 72 3996 Hawaii Belt Rd, Kailua Kona, HI 96740 | 2017-02-22 |
| 1255787974 | John Fujita | Pharmacist | 74-5456 Kamakaeha Ave, Kailua Kona, HI 96740 | 2016-05-11 |
| 1326425083 | Lauren Deweese | Massage Therapist | 76-6194 Holualoa Beach Rd, Unit 6, Kailua-kona, HI 96740 | 2015-05-01 |
| 1073907754 | Kathleen Marie Coyle | Massage Therapist | 76-217 Keakealani Street, Kailua Kona, HI 96740 | 2015-03-20 |
| 1841609971 | Shellie R Norman | Nurse Practitioner | 75-5995 Kuakini Hwy Ste 443&445, Kailua Kona, HI 96740 | 2014-08-01 |
| Find all providers in zip 96740 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578160909 | Usrc Waianae, LLC | Clinic/Center | 86-120 Farrington Hwy Ste B211, Waianae, HI 96792-3072 | 2020-10-08 |
| 1447872395 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 2226 Liliha St Fl 2, Honolulu, HI 96817-1600 | 2020-05-14 |
| 1164059168 | Usrc Ewa Beach, LLC | Clinic/Center | 91-919 Fort Weaver Rd Ste 110, Ewa Beach, HI 96706-2257 | 2020-03-27 |
| 1467971465 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 500 Ala Moana Blvd Ste 7302, Honolulu, HI 96813 | 2017-09-12 |
| 1073060638 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 4380 Lumehana Street, Honolulu, HI 96818-3137 | 2016-09-01 |
| 1366804478 | Usrc Beretania, LLC | Clinic/Center | 1908 S Beretania St, Honolulu, HI 96826-1308 | 2016-03-28 |
| 1487037206 | Liberty Dialysis Hawaii LLC | Clinic/Center | 10 Hoohui Rd Ste 100, Lahaina, HI 96761-9257 | 2015-06-30 |
| 1881075414 | Dialysis Newco Inc | Clinic/Center | 889 Kamokila Blvd, Kapolei, HI 96707-2061 | 2015-06-09 |
| 1497017495 | Dialysis Newco Inc | Clinic/Center | 94-862 Kahuailani St, Waipahu, HI 96797-3341 | 2012-06-14 |
| 1164684825 | Liberty Dialysis - Hawaii LLC | Clinic/Center | 94-450 Mokuola St, Waipahu, HI 96797-3300 | 2008-06-25 |
| Find all providers with the same taxonomy | ||||
| City | KAILUA KONA |
| Zip Code | 96740 |
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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.