Luis Guillermo Carmona, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A1890 Issued in MD

Practice address

16 Fusting Ave
Catonsville, MD 21228-4413

Phone

(410) 747-1800

NPI assigned

Nov 12, 2013

Last updated

Nov 12, 2013By 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 2

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": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1265861280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4918 ORCHARD DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436725",
            "telephone_number": "410-203-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 FUSTING AVE",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284413",
            "telephone_number": "410-747-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMONA",
        "first_name": "LUIS",
        "middle_name": "GUILLERMO",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-12",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "A1890",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A1890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Physical Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.