Active NPI
Amy Boozer Moyer, PT
- Pediatric Physical Therapist
- Evans, GA
National Provider Identifier
1023170602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 002820
- Practice address
- 4405 Evans to Locks Rd
Suite C
Evans, GA 30809-3603 - Phone
- (706) 854-1598
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 002820 | GA | Primary |
Addresses
Primary practice location
4405 Evans to Locks Rd
Suite C
Evans, GA 30809-3603
Mailing address
202 Folkstone Cir
Augusta, GA 30907-3773
Phone (706) 860-8731
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00650075D | Medicaid | GA |
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 |
|---|---|---|---|
| 002820 | GA | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| In Home Pediatric Therapy Inc | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023170602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 FOLKSTONE CIR",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309073773",
"telephone_number": "706-860-8731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4405 EVANS TO LOCKS RD",
"address_2": "SUITE C",
"city": "EVANS",
"state": "GA",
"postal_code": "308093603",
"telephone_number": "706-854-1598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYER",
"first_name": "AMY",
"middle_name": "BOOZER",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "GA",
"license": "002820",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00650075D",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evans, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.