SOUTH SHORE PHYSICAL THERAPY & SPORTSMEDICINE (NPI# 1962769984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962769984 |
| Entity Type | Organization |
| Organization Name | SOUTH SHORE PHYSICAL THERAPY & SPORTSMEDICINE |
| Other Organization Name | IMUA PHYSICAL THERAPY |
| Practice Address |
4310 Lower Honoapiilani Rd Ste. 110 Lahaina HI 96761-9246 |
| Practice Telephone | 8088790077 |
| Practice Fax Number | 8088790177 |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2012-09-06 |
| Authorized Official Name | MRS. TIFFANY GRACE PRANGNELL (OWNER/PRESIDENT) |
| Authorized Official Telephone | 8088790077 |
| Authorized Official Credential | MPT, ATC, CLT, C |
| 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 |
|---|---|
| Imua Physical Therapy | Doing Business As Name - Organization |
| Street Address |
4310 LOWER HONOAPIILANI RD STE. 110 |
| City | LAHAINA |
| State | HI |
| Zip Code | 96761-9246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639147267 | Shantelle Lea Pierce | Physical Therapist | 4310 Lower Honoapiilani Rd, #110, Lahaina, HI 96761-9246 | 2006-03-09 |
| 1457689994 | Kathleen B Roberts | Physical Therapist | 4310 Lower Honoapiilani Rd, Suite 110, Lahaina, HI 96761-9246 | 2009-11-20 |
| 1285718940 | Lisa M Hoogasian | Physical Therapist | 4310 Lower Honoapiilani Rd, Suite 110, Lahaina, HI 96761-9246 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366901472 | Bridgette Grant Lcsw LLC | Clinic/Center | 4435 Lower Honoapiillani Rd, 142, Lahaina, HI 96761 | 2019-03-18 |
| 1366821803 | Stephen Barba | Student in an Organized Health Care Education/Training Program | 154 Papalaua Street, Suite #200, Lahaina, HI 96761 | 2015-05-28 |
| 1538546866 | Christine Marie Mora | Specialist | 12 Alamoana St #a, Lahaina, HI 96761 | 2015-05-06 |
| 1982009502 | Chelsea J North | Massage Therapist | 181 Lahainaluna Road, Suite D, Lahaina, HI 96761 | 2014-10-24 |
| 1427495860 | Chandy-ann Leinaala Lopes | Naturopath | 180 Dickenson St Ste 218, Lahaina, HI 96761 | 2013-05-24 |
| 1245554138 | David Wing Lee | Podiatrist | 40 Kupuohi St Ste 204, Lahaina, HI 96761 | 2010-03-21 |
| 1871736298 | Joal Breece Dennis Sr. | Marriage & Family Therapist | 980 Front St., Lahaina, HI 96761 | 2009-04-15 |
| 1053564526 | Community Clinic of Maui Inc | Clinic/Center | 15 Ipu Aumakua Ln, Lahaina, HI 96761 | 2008-10-28 |
| 1104009091 | State of Hawaii Department of Health | Community/Behavioral Health | 1830 Hooapiilani Highway, Lahaina, HI 96761 | 2007-12-13 |
| 1659412021 | Jacoby Inc. | Acupuncturist | 930 Wainee Street, Suite 10, Lahaina, HI 96761 | 2007-02-09 |
| Find all providers in zip 96761 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114354198 | South Shore Pt & Sportsmedicine, Inc. | Clinic/Center | 40 Kupuohi St, Suite 105, Lahaina, HI 96761-2741 | 2013-10-04 |
| 1235560657 | Southshore Physical Therapy & Sportsmedicine | Clinic/Center | 3350 Lower Honoapiilani Rd Ste 214, Lahaina, HI 96761-8404 | 2013-12-11 |
| 1922260264 | Lahaina Physical Therapy LLC | Clinic/Center | 180 Dickenson St, Suite 206, Lahaina, HI 96761-1215 | 2008-06-27 |
| 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.