HAWAI'I SPORTS PERFORMANCE AND REHABILITATION LLC (NPI# 1205302452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205302452 |
| Entity Type | Organization |
| Organization Name | HAWAI'I SPORTS PERFORMANCE AND REHABILITATION LLC |
| Practice Address |
75-5660 Kopiko St Kailua Kona HI 96740-3611 |
| Mailing Address |
76-6167 Alii Dr Kailua Kona HI 96740-2387 |
| Practice Telephone | 3049421726 |
| Mailing Telephone | 3049421726 |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2018-10-15 |
| Authorized Official Name | DR. GENELLE BOTJE (DOCTOR OF PHYSICAL THERAPY) |
| Authorized Official Telephone | 3049421726 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | CAQH | 12669923 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 75-165 Hualalai Rd, Kailua Kona, HI 967403722 | 3049421726 |
| Street Address |
75-5660 KOPIKO ST |
| City | KAILUA KONA |
| State | HI |
| Zip Code | 96740-3611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568672756 | Garrett B.k. Oka | Dentist | 75-5660 Kopiko St, #b2, Kailua Kona, HI 96740-3611 | 2007-05-23 |
| 1417579087 | Carly Kauwela Neal | Physical Therapist | 75-5660 Kopiko St, Kailua Kona, HI 96740-3611 | 2020-05-17 |
| 1083113856 | Victoria Anne Giffen | Physical Therapist | 75-5660 Kopiko St, Kailua Kona, HI 96740-3611 | 2018-02-07 |
| 1710307277 | Compassionate Home Care | Chore Provider | 75-5660 Kopiko St, Suite C-7 #112, Kailua Kona, HI 96740-3611 | 2014-04-23 |
| 1386989622 | Ramin Nikkhoo | Chiropractor | 75-5660 Kopiko St, C7-280, Kailua Kona, HI 96740-3611 | 2012-11-27 |
| 1326229568 | Michael Sansone | Chiropractor | 75-5660 Kopiko St, Suite C7-348, Kailua Kona, HI 96740-3611 | 2007-11-15 |
| 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 | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811092406 | Club Rehab, Inc. | Clinic/Center | 75 5699 Kopiko St, Kailua Kona, HI 96740-3651 | 2006-09-14 |
| 1972927119 | Therapydia, Inc. | Clinic/Center | 78-6831 Alii Dr, #420, Kailua Kona, HI 96740-2495 | 2014-02-07 |
| 1194156604 | Life Care Center of Kona | Clinic/Center | 78-6957 Kamehameha IIi Rd, Kailua Kona, HI 96740-2528 | 2013-12-09 |
| 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 | ||||
| City | KAILUA KONA |
| Zip Code | 96740 |
Please comment or provide details below to improve the information on HAWAI'I SPORTS PERFORMANCE AND REHABILITATION LLC.
| 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.