Individual provider Active NPI

Charlotte Liddell, DC

  • Chiropractor
  • Kapa'a, HI
National Provider Identifier
1306936356
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC552 Issued in HI
Practice address
4569 Kukui St
Kapaa, HI 96746-1775
Phone
(808) 652-8029
NPI assigned
Oct 13, 2006
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC552 HI Primary

Addresses

Primary practice location

4569 Kukui St
Kapaa, HI 96746-1775

Mailing address

4754 Pelehu Rd
Kapaa, HI 96746-1825
Phone (808) 652-8029

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC552HIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Network Wellness Center Inc Chiropractor CurrentSince Sep 21, 2004 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1306936356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4754 PELEHU RD",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967461825",
            "telephone_number": "808-652-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4569 KUKUI ST",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967461775",
            "telephone_number": "808-652-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDELL",
        "first_name": "CHARLOTTE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "DC552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapa'a, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.