Alena Bolshakova, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2157760 Issued in TX

Practice address

3120 Sun Drenched Path
Austin, TX 78732-1950

Phone

(404) 493-1628

NPI assigned

Oct 13, 2020

Sex

Female

Sole proprietor

Yes

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": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1922606862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 SUN DRENCHED PATH",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787321950",
            "telephone_number": "404-493-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 SUN DRENCHED PATH",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787321950",
            "telephone_number": "404-493-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLSHAKOVA",
        "first_name": "ALENA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2157760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mamatha Bollineni, M.D.
• Keri Lynn Bollman, PA-C
• Brennan Bollmer
• Heidi A Bollock, CNS
• Tom N Bolls, LPC
• Kim P Bolton, MD
• Larry Edward Bolton Jr., PA-C
• Ross Matthew Bomben, D.C.
• Jennifer Bommer, LPC-I
• Nicole Bonar, CRNP

• Physical Therapy Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.