Kiera Destiny Glodowski

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT-395 Issued in HI

Practice address

1337 Lower Campus Rd Ofc 224
Honolulu, HI 96822-2352

Phone

(808) 956-7606

NPI assigned

Jan 17, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1033860440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 LOWER CAMPUS RD OFC 224",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968222352",
            "telephone_number": "808-956-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 LOWER CAMPUS RD OFC 224",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968222352",
            "telephone_number": "808-956-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLODOWSKI",
        "first_name": "KIERA",
        "middle_name": "DESTINY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-17",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "HI",
            "license": "AT-395",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "UT",
            "license": "12322664-4810",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "HI",
            "license": "12322664-4810",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "HI",
            "license": "AT-395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Athletic Trainer in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.