KA WAI OLA MEDICAL CLINIC LLC (NPI# 1487102877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487102877 |
Entity Type | Organization |
Organization Name | KA WAI OLA MEDICAL CLINIC LLC |
Practice Address |
16-590 Old Volcano Rd Ste. A Keaau HI 96749-8158 |
Mailing Address |
1695 Auwae Rd Hilo HI 96720-6908 |
Practice Telephone | 8087960168 |
Mailing Telephone | 8087960168 |
Enumeration Date | 2016-09-14 |
Last Update Date | 2016-09-14 |
Authorized Official Name | LEILANI KERR (OWNER) |
Authorized Official Telephone | 8087960168 |
Authorized Official Credential | APRN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
APRN-1450 | HI | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
HI | MEDICARE PTAN | 11105633 | 01 |
HI | HMSA PROVIDER | 00A0324531 | 01 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | KA WAI OLA MEDICAL CLINIC LLC | 16-590 Old Volcano Rd, Keaau, HI 96749-8158 |
Street Address |
16-590 OLD VOLCANO RD STE. A |
City | KEAAU |
State | HI |
Zip Code | 96749-8158 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992290811 | Back To Basics Chiropractic | Chiropractor | 16-590 Old Volcano Rd, Keaau, HI 96749 | 2018-06-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194326959 | Presence of Mind Inc | Counselor | 15-1942 7th Ave., Keaau, HI 96749 | 2020-11-06 |
1700498102 | Thomas Gerard Camenzind | Massage Therapist | 16-426 Brookover Street, Keaau, HI 96749 | 2020-08-18 |
1225674542 | Jennifer Archer | Behavior Technician | 16-556 Kea'au Pahoa Rd, 188-111, Kea'au, HI 96749 | 2019-11-21 |
1124672712 | Jill Jenkins | Registered Nurse | 15-1680 9th Ave, Keaau, HI 96749 | 2019-07-31 |
1467004135 | Evelyn Ramelb | Nursing Home Administrator | 16-1508 35th Ave, Keaau, HI 96749 | 2019-07-12 |
1326690157 | Samuel Robert Teare IIi | Behavior Technician | 16-359 Kehaulani St, Keaau, HI 96749 | 2019-07-11 |
1942869599 | Tisha Takazawa | Community Health Worker | 16-204 Melekahiwa Place, Suite 3, Keaau, HI 96749 | 2019-06-07 |
1154824407 | Kipuka Counseling and Consulting, LLC | Community/Behavioral Health | 15-1463 Awa Ave, Keaau, HI 96749 | 2018-03-13 |
1598272536 | Alexander Stitt | Counselor | 15-1963 4th Ave., Keaau, HI 96749 | 2017-12-29 |
1164937223 | Rachael Lorraine Hasner | Registered Nurse | 15-1488 Lokelani Ave, Keaau, HI 96749 | 2017-12-11 |
Find all providers in zip 96749 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
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1497371348 | Vinson K Diep Md Inc | Clinic/Center | 1319 Punahou St Ste 1190, Honolulu, HI 96826-1089 | 2020-06-16 |
1891324471 | Compcare, LLC | Clinic/Center | 94-997 Hanauna St 5f, Waipahu, HI 96797 | 2020-04-05 |
1093348161 | Amh Series II, Hi, LLC | Clinic/Center | 415 Uluniu St Ste D, Kailua, HI 96734-2503 | 2020-02-18 |
1417592254 | Nancy S. Clarke, M.d. LLC | Clinic/Center | 98-211 Pali Momi St Ste 800, Aiea, HI 96701-4370 | 2019-11-15 |
1972071538 | Foundaton Research | Clinic/Center | 1314 S King St Ste 653, Honolulu, HI 96814-1979 | 2018-11-12 |
1962929398 | Mark T. Kuge,md,inc | Clinic/Center | 1481 S King St Ste 310, Honolulu, HI 96814-2684 | 2017-08-25 |
1346784139 | East Maui Medical Clinic, LLP | Clinic/Center | 4950 Uakea Road, Unit 2, Hana, HI 96713-0278 | 2016-12-13 |
1790230480 | Emi Ota, M.d., Inc. | Clinic/Center | 850 W Hind Dr Ste 205, Honolulu, HI 96821-1845 | 2016-08-23 |
1962853317 | Sheareen Gedayloo Md LLC | Clinic/Center | 1028 Kinoole St Ste 101, Hilo, HI 96720-3800 | 2016-06-27 |
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.