Charles Ay Wagner, RN, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 2674 Issued in HI

Practice address

69 Railroad Ave Ste A4
Hilo, HI 96720-7509

Phone

(808) 339-7861

NPI assigned

Jun 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Core Wellness Hawaii LLCGroup PAC ID 6406126762, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Core Wellness Hawaii LLC

  • Physical Therapy Clinic/Center
  • Hilo, HI
  • NPI 1003348400

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134326549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25-3420 PAKELEKIA ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967201318",
            "telephone_number": "808-989-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 RAILROAD AVE STE A4",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967207509",
            "telephone_number": "808-339-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CHARLES",
        "middle_name": "AY",
        "name_prefix": "Dr.",
        "credential": "RN, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT 2674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jadaisha Waahila
• Waliyyuddin Waarith
• John L Wade, MD
• Megan Wade, PA-C
• Robby A. Wade, L.AC.
• Erin L Wagner, PTA, LMT
• Rochelle Sabrina Wagner, LMFT
• Wai Kahe Counseling, LLC
• Cornelia C Waiau, LMFT
• Cory K Wakano, D.D.S.

• Physical Therapist in Hilo, HI
• Providers in Hilo, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.