Lucas Penaloza Gutierrez

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A8033 Issued in NC

Practice address

3864 Sweeten Creek Rd
Arden, NC 28704-3136

Phone

(828) 681-0904

NPI assigned

Apr 4, 2023

Last updated

Apr 4, 2023By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1023713435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 BRYSON RD",
            "city": "CANDLER",
            "state": "NC",
            "postal_code": "287159573",
            "telephone_number": "828-767-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3864 SWEETEN CREEK RD",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287043136",
            "telephone_number": "828-681-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "LUCAS",
        "middle_name": "PENALOZA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A8033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Griffith, AGPCNP-BC
• Riley Groenewoud, PT, DPT
• Ryan Edward Groth, PA
• Leah Alexa Guarino, LCMHC, NCC
• Elizabeth Katherine Guesdon, MS, OTR/L
• Alma Hachey
• Molly Elyse Hahn-Floyd, OTD, OTR/L
• Melinda Michelle Halford, LPCA
• Kimberly Hanchett, PT, DPT
• Carol Julie Haney, LPTA

• Physical Therapy Assistant in Arden, NC
• Providers in Arden, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.