Active NPI
Carlos Rene Castillo, PTA
- Physical Therapy Assistant
- Springdale, AR
National Provider Identifier
1487087763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA 2139
- Practice address
- 1112 S 48TH St
Springdale, AR 72762-5848 - Phone
- (479) 751-3900
- Fax
- (479) 751-3011
- NPI assigned
- Aug 9, 2013
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA 2139 | AR | Primary |
Addresses
Primary practice location
1112 S 48TH St
Springdale, AR 72762-5848
Mailing address
PO Box 871
Tontitown, AR 72770-0871
Phone (479) 444-6277
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 |
|---|---|---|---|
| PTA 2139 | AR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376265600000",
"number": "1487087763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 871",
"city": "TONTITOWN",
"state": "AR",
"postal_code": "727700871",
"telephone_number": "479-444-6277",
"fax_number": "479-444-6278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1112 S 48TH ST",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727625848",
"telephone_number": "479-751-3900",
"fax_number": "479-751-3011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTILLO",
"first_name": "CARLOS",
"middle_name": "RENE",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-09",
"last_updated": "2013-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AR",
"license": "PTA 2139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.