Scott G Boswell

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA004705 Issued in GA

Practice address

1611 Lawrenceville Suwanee Rd
Lawrenceville, GA 30043-3593

Phone

(678) 391-4373

NPI assigned

Aug 2, 2021

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": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1073287355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5039 WEATHERSTONE DR",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305191987",
            "telephone_number": "714-404-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 LAWRENCEVILLE SUWANEE RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433593",
            "telephone_number": "678-391-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSWELL",
        "first_name": "SCOTT",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA004705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Boone-Sanford, PH.D.
• Boostcare LLC
• Jacqueline Boreland, RN
• Ashley Attaway Born
• Angela Bostic-Maddox
• John David Botero, NP-C
• Manuela Botero
• James L Bouchard, DPM
• Angel Brown Boulware, FNP-C
• Renee Bouy, CCC-SLP

• Physical Therapy Assistant in Lawrenceville, GA
• Providers in Lawrenceville, 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 Aug 2, 2021; 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.