Active NPI
Richard Robert Watts, ATC
- Athletic Trainer
- Kailua Kona, HI
National Provider Identifier
1861886483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-186
- Practice address
- 74-5000 Puohulihuli St
Kailua Kona, HI 96740-3318 - Phone
- (808) 313-3787
- NPI assigned
- Mar 20, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-186 | HI | Primary |
Addresses
Primary practice location
74-5000 Puohulihuli St
Kailua Kona, HI 96740-3318
Mailing address
PO Box 2764
Kailua Kona, HI 96745-2764
Phone (808) 960-8763
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT-186 | HI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426809600000",
"number": "1861886483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2764",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967452764",
"telephone_number": "808-960-8763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74-5000 PUOHULIHULI ST",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967403318",
"telephone_number": "808-313-3787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "RICHARD",
"middle_name": "ROBERT",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-20",
"last_updated": "2015-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "HI",
"license": "AT-186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kailua Kona, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.