Individual provider Active NPI

Charles Angelopoulos, ATC

  • Athletic Trainer
  • Lake Placid, NY
National Provider Identifier
1104750785
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
4 Bonnie Dr
Lake Placid, NY 12946-3062
Phone
(518) 524-1187
Fax
(518) 523-7889
NPI assigned
Jun 10, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X NY Primary

Addresses

Primary practice location

4 Bonnie Dr
Lake Placid, NY 12946-3062

Mailing address

4 Bonnie Dr
Lake Placid, NY 12946-3062
Phone (518) 524-1187

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

NPI Registry JSON

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

{
    "created_epoch": "1781049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1104750785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BONNIE DR",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "129463062",
            "telephone_number": "518-524-1187",
            "fax_number": "518-523-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BONNIE DR",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "129463062",
            "telephone_number": "518-524-1187",
            "fax_number": "518-523-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELOPOULOS",
        "first_name": "CHARLES",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-10",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Placid, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.