Rolando Argeniz Pena-Larios, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA004955 Issued in GA

Practice address

3991 Highway 78 W Ste 200
Snellville, GA 30039-3929

Phone

(470) 482-6933

Fax

(470) 482-6940

NPI assigned

Oct 21, 2022

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": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1669199675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2833 AUSTIN RIDGE DR",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300196108",
            "telephone_number": "470-338-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3991 HIGHWAY 78 W STE 200",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300393929",
            "telephone_number": "470-482-6933",
            "fax_number": "470-482-6940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 Scenic Highway South, suite 100",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "30078",
            "country_code": "US",
            "telephone_number": "678-535-5030",
            "fax_number": "678-293-8563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA-LARIOS",
        "first_name": "ROLANDO",
        "middle_name": "ARGENIZ",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA004955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Snellville, GA
• Providers in Snellville, 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 Oct 21, 2022; 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.