Active NPI
Charles Roggow, ATC
- Athletic Trainer
- Pukalani, HI
National Provider Identifier
1063606937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2255A2300X
- Practice address
- 270 A 'Apueo Parkway
Pukalani, HI 96768 - Phone
- (808) 573-7108
- NPI assigned
- Sep 4, 2007
- Last updated
- Sep 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2255A2300X | HI | Primary |
Addresses
Primary practice location
270 A 'Apueo Parkway
Pukalani, HI 96768
Mailing address
124 Aleiki PL
Paia, HI 96779-9716
Phone (808) 579-8626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2255A2300X | HI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188864000000",
"number": "1063606937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 ALEIKI PL",
"city": "PAIA",
"state": "HI",
"postal_code": "967799716",
"telephone_number": "808-579-8626",
"fax_number": "808-579-8630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "270 A 'APUEO PARKWAY",
"city": "PUKALANI",
"state": "HI",
"postal_code": "96768",
"telephone_number": "808-573-7108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGGOW",
"first_name": "CHARLES",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-04",
"last_updated": "2007-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "HI",
"license": "2255A2300X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pukalani, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.