Dna Active Rehab and Performance, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-2354 Issued in HI

Legal business name

DNA ACTIVE REHAB AND PERFORMANCE, LLC

Practice address

771 Amana St # 201
Honolulu, HI 96814-3238

Phone

(808) 375-0968

Fax

(866) 446-2433

NPI assigned

Sep 3, 2013

Organization subpart

No

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

Authorized official

Name

Kenneth Nakasone, DPT, ATC

Title

Co-Owner/Physical Therapist

Phone

(808) 375-0968

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1548695000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 AMANA ST # 201",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143238",
            "telephone_number": "808-375-0968",
            "fax_number": "866-446-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 AMANA ST # 201",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143238",
            "telephone_number": "808-375-0968",
            "fax_number": "866-446-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DNA ACTIVE REHAB AND PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-03",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "NAKASONE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CO-OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "808-375-0968",
        "authorized_official_credential": "DPT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-2354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1932269297",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.