Carlos Manuel Santiago, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA002862 Issued in GA

Practice address

100 Lindsey LN # a
Kingsland, GA 31548-6850

Phone

(912) 729-1333

Fax

(912) 729-5259

NPI assigned

Nov 8, 2011

Sex

Male

Sole proprietor

No

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1639456445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620949",
            "telephone_number": "706-236-2774",
            "fax_number": "706-802-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LINDSEY LN # A",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486850",
            "telephone_number": "912-729-1333",
            "fax_number": "912-729-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "CARLOS",
        "middle_name": "MANUEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA002862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Ross, LDO
• Sarah Roupp
• Ruxandra Mares, MD
• Martha Patricia Sanchez-Silva, M.D.
• Matthew Parrish Sands, DMD
• Christina Monica Scarlett, MSN,APRN, FNP-C
• Lisa Beth Schopf, MS.,CCC-SLP
• Stephanie Schow, FNP
• Jenna R Seay
• Marsha Shackelford, PT

• Physical Therapy Assistant in Kingsland, GA
• Providers in Kingsland, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.