NPI |
1023524279 |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
Entity Type Code |
1 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider Last Name Legal Name |
WRIGHT |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider First Name |
GARY |
The first name of the provider, if the provider
is an individual. |
Provider Name Prefix Text |
MR. |
The name prefix or salutation of the provider
if the provider is an individual; for example, Mr., Mrs., or Corporal. |
Provider Name Suffix Text |
JR. |
The name suffix of the provider if the provider
is an individual. The name suffix is a ‘‘generation-related’’ suffix, such as Jr., Sr., II, III, IV, or V. |
Provider First Line Business Practice Location Address |
98-939 MOANALUA RD |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address City Name |
AIEA |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address State Name |
HI |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
967015012 |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
8552237123 |
The country code in the location address of the provider being identified. |
Provider Enumeration Date |
12/26/2017 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Last Update Date |
7/12/2021 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Gender Code |
M |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Taxonomy Code 1 |
106E00000X |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Healthcare Provider Taxonomy Code 2 |
106S00000X |
|
Healthcare Provider Primary Taxonomy Switch 2 |
N |
|
Is Sole Proprietor |
N |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
NPI Certification Date |
7/12/2021 |
|