Individual provider Active NPI

Charlie Dale Tortona Ramos, PTA

  • Physical Therapy Assistant
  • Grand Prairie, TX
National Provider Identifier
1528506789
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2121409 Issued in TX
Practice address
3055 Bardin Rd
#200
Grand Prairie, TX 75052-3816
Phone
(672) 522-2200
NPI assigned
Feb 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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 2121409 TX Primary

Addresses

Primary practice location

3055 Bardin Rd
#200
Grand Prairie, TX 75052-3816

Mailing address

1551 N State Highway 161
Apt 1811
Grand Prairie, TX 75050-7077
Phone (310) 259-1878

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
2121409TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1528506789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 N STATE HIGHWAY 161",
            "address_2": "APT 1811",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750507077",
            "telephone_number": "310-259-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 BARDIN RD",
            "address_2": "#200",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523816",
            "telephone_number": "672-522-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "CHARLIE DALE",
        "middle_name": "TORTONA",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2121409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.