Individual provider Active NPI

Erin Shea Antolinez, PTA

  • Physical Therapy Assistant
  • Rome, GA
National Provider Identifier
1275990384
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
003521 Issued in GA
Practice address
809 S Broad St SW
Rome, GA 30161-4654
Phone
(404) 632-2336
NPI assigned
Jan 20, 2016
Last updated
Jan 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 003521 GA Primary

Addresses

Primary practice location

809 S Broad St SW
Rome, GA 30161-4654

Mailing address

3633 Longfellow TRL
Marietta, GA 30062-5178
Phone (404) 632-2336

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

LicenseStateTypeSpecialty
003521GAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1275990384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 LONGFELLOW TRL",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625178",
            "telephone_number": "404-632-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 S BROAD ST SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301614654",
            "telephone_number": "404-632-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOLINEZ",
        "first_name": "ERIN",
        "middle_name": "SHEA",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "003521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; 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.