Active NPI
Casey Matthew Boyd, PT, DPT
- Physical Therapist
- Rockford, IL
National Provider Identifier
1033716485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.025465
- Practice address
- 5510 E State St
Rockford, IL 61108-2381 - Phone
- (815) 395-4505
- NPI assigned
- Oct 7, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.025465 | IL | Primary |
Addresses
Primary practice location
5510 E State St
Rockford, IL 61108-2381
Mailing address
5645 Courtland Cir
Rockford, IL 61109-3900
Phone (815) 218-9645
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.025465 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1033716485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5645 COURTLAND CIR",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611093900",
"telephone_number": "815-218-9645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5510 E STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082381",
"telephone_number": "815-395-4505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "CASEY",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-07",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.025465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.