Individual provider Active NPI

Robert S. Charles-Liscombe, ATC

  • Athletic Trainer
  • Greensboro, NC
National Provider Identifier
1104890037
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0076 Issued in NC
Practice address
815 W Market St
Division of Kinesiology
Greensboro, NC 27401-1823
Phone
(336) 272-7102
Fax
(336) 217-7237
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 0076 NC Primary

Addresses

Primary practice location

815 W Market St
Division of Kinesiology
Greensboro, NC 27401-1823

Mailing address

6702 Poplar Grove TRL
Greensboro, NC 27410-8629
Phone (336) 664-6248

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

LicenseStateTypeSpecialty
0076NCMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104890037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6702 POPLAR GROVE TRL",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274108629",
            "telephone_number": "336-664-6248",
            "fax_number": "336-217-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W MARKET ST",
            "address_2": "DIVISION OF KINESIOLOGY",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011823",
            "telephone_number": "336-272-7102",
            "fax_number": "336-217-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES-LISCOMBE",
        "first_name": "ROBERT",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "0076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.