Brock A. Charleston, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 2676 Issued in HI

Practice address

161 Wailea Ike PL Ste A105
Kihei, HI 96753-6502

Phone

(808) 661-5266

Fax

(808) 661-5264

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Lahaina Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Kihei, HI
  • NPI 1922260264

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Lahaina Physical Therapy, Inc.

  • Physical Therapist
  • Lahaina, HI
  • NPI 1447314851
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1861592123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967530215",
            "telephone_number": "808-661-5266",
            "fax_number": "808-661-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 WAILEA IKE PL STE A105",
            "city": "KIHEI",
            "state": "HI",
            "postal_code": "967536502",
            "telephone_number": "808-661-5266",
            "fax_number": "808-661-5264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Lono Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Kahului",
            "state": "HI",
            "postal_code": "967321610",
            "country_code": "US",
            "telephone_number": "808-661-5266",
            "fax_number": "808-661-5264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLESTON",
        "first_name": "BROCK",
        "middle_name": "A.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT 2676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Shennan Causey, LMT
• Laura Veronica Cavanaugh, LMT
• Stephanie Cefali, LMT
• Dominic Cerra, PHARM BS
• Charles H Ballard Inc
• Jennifer Ann Chase, DPT, MS
• Brian P Chenes, D.C.
• Cheryl E. Ayabe, O.D., Inc.
• Victoria Chicca
• Dinah Childress

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.