Active NPI
Vernon Charles III, COTA
- Occupational Therapy Assistant
- Honolulu, HI
National Provider Identifier
1902275191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 347662
- Practice address
- 2230 Liliha St
Honolulu, HI 96817-1646 - Phone
- (808) 547-6500
- NPI assigned
- Sep 18, 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 347662 | HI | Primary |
Addresses
Primary practice location
2230 Liliha St
Honolulu, HI 96817-1646
Mailing address
4964 Kilauea Ave
Unit #1
Honolulu, HI 96816-5724
Phone (808) 428-8884
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 |
|---|---|---|---|
| 347662 | HI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442534400000",
"number": "1902275191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4964 KILAUEA AVE",
"address_2": "UNIT #1",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968165724",
"telephone_number": "808-428-8884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2230 LILIHA ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968171646",
"telephone_number": "808-547-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES",
"first_name": "VERNON",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-18",
"last_updated": "2015-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "HI",
"license": "347662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.