Basic Information
| Provider Information | |||||||||
| NPI: | 1598859126 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | PEGGY | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 354 ULUNIU ST | ||||||||
| Address2: | STE 404 | ||||||||
| City: | KAILUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967342534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082621118 | ||||||||
| FaxNumber: | 8082620045 | ||||||||
| Practice Location | |||||||||
| Address1: | 354 ULUNIU STREET | ||||||||
| Address2: | SUITE 404 | ||||||||
| City: | KAILUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082621118 | ||||||||
| FaxNumber: | 8082620045 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT1959 | HI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | A0243046 | 01 | HI | KAI HMSA PPO/HMO/QST/65C | OTHER | 0243048 | 01 | HI | TRICARE HNL | OTHER | 0681318 | 01 | HI | UHA 99-0332020 | OTHER | 506371 | 01 | HI | HMA | OTHER | 54014701 | 05 | HI | MEDICAID | 99-0332020 | 01 | HI | HMAA | OTHER | 54014702 | 05 | HI | MEDICAID | 0243048 | 01 | HI | HNL HMSA PPO/HMO/QST/65C | OTHER | 204196700 | 01 | HI | OWCP | OTHER | 54014700 | 01 | HI | ALOHA CARE | OTHER | A0243046 | 01 | HI | TRICARE KAI | OTHER |