Basic Information
| Provider Information | |||||||||
| NPI: | 1982797411 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOCKETTE | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | R.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 481-C KAWAILOA ROAD | ||||||||
| Address2: | |||||||||
| City: | KAILUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082611514 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1314 SOUTH KING STREET | ||||||||
| Address2: | SUITE 1451 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085932610 | ||||||||
| FaxNumber: | 8085919420 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1258 | HI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 0137318 | 01 | HI | UHA 99033202001 | OTHER | 193484 | 01 | HI | HMA | OTHER | 49355200 | 01 | HI | ALOHA CARE | OTHER | F0226446 | 01 | HI | TRICARE KAI | OTHER | A22644-7 | 01 | HI | HNL HMSA PPO/HMO/QST/65C | OTHER | 49355204 | 05 | HI | MEDICAID | A22644-7 | 01 | HI | TRICARE HNL | OTHER | 49355201 | 05 | HI | MEDICAID | F0226446 | 01 | HI | KAI HMSA PPO/HMO/QST/65C | OTHER |