KELLIE M. O. TAKASHIMA NP NPI 1568544401

NPI Information

  • NPI: 1568544401
  • Provider Name: KELLIE M. O. TAKASHIMA, NP
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • Address: 30 BROAD ST FL 45
    NEW YORK, NY
    ZIP 10004
  • Phone: (212) 530-0630

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NPI Details

Kellie M. O. Takashima, NP is a nurse practitioner in New York, NY. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Kellie M. O. Takashima, NP NPI is 1568544401. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

30 BROAD ST FL 45
NEW YORK, NY
ZIP 10004-942
Phone: (212) 530-0630

The enumeration date for this NPI number is 10/19/2006 and was last updated on 2/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyAP7772ARIZONANo
2363LF0000XNurse PractitionerFamilyAP60755079WASHINGTONNo
3363LF0000XNurse PractitionerFamilyRN2300400MASSACHUSETTSNo
4363L00000XNurse Practitioner339604NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10000220004OTHERHAWAIIHMSA BILLING NUMBER
255037802MEDICAIDHAWAII

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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