CLUB REHAB, INC. (NPI# 1811092406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811092406 |
| Entity Type | Organization |
| Organization Name | CLUB REHAB, INC. |
| Practice Address |
75 5699 Kopiko St Kailua Kona HI 96740-3651 |
| Practice Telephone | 8083297744 |
| Practice Fax Number | 8083341608 |
| Mailing Telephone | 8083297744 |
| Mailing Fax Number | 8083341608 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2015-05-29 |
| Authorized Official Name | GORDAN DONG (PRESIDENT) |
| Authorized Official Telephone | 8083297744 |
| Authorized Official Credential | P.T. |
| 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 |
| Street Address |
75 5699 KOPIKO ST |
| City | KAILUA KONA |
| State | HI |
| Zip Code | 96740-3651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477612158 | Tlc Chiropractic, LLC | Health Maintenance Organization | 75 5699 Kopiko St, Kailua Kona, HI 96740 | 2006-12-08 |
| 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 |
|---|---|---|---|---|
| 1205302452 | Hawai'i Sports Performance and Rehabilitation LLC | Clinic/Center | 75-5660 Kopiko St, Kailua Kona, HI 96740-3611 | 2018-10-15 |
| 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 |
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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.