Individual provider Active NPI

Charles E Rainey, PT

  • Physical Therapist
  • Jbphh, HI
National Provider Identifier
1710326376
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2009019317 Issued in MO
Practice address
1253 Makalapa Rd
BLDG 1514
Jbphh, HI 96860-4479
Phone
(808) 473-2444
Fax
(619) 437-5614
NPI assigned
Jun 17, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 2009019317 MO
Orthopedic Physical Therapist 2251X0800X 2009019317 MO
Physical Therapist 225100000X 2009019317 MO Primary
Clinical Electrophysiology Physical Therapist 2251E1300X 2009019317 MO

Addresses

Primary practice location

1253 Makalapa Rd
BLDG 1514
Jbphh, HI 96860-4479

Mailing address

2211 Bancroft Dr
Kailua, HI 96734-6230
Phone (417) 766-4785

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
2009019317MOMDSports Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1710326376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 BANCROFT DR",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967346230",
            "telephone_number": "417-766-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 MAKALAPA RD",
            "address_2": "BLDG 1514",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968604479",
            "telephone_number": "808-473-2444",
            "fax_number": "619-437-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINEY",
        "first_name": "CHARLES",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MO",
            "license": "2009019317",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "2009019317",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2009019317",
            "primary": true
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "MO",
            "license": "2009019317",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbphh, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.