Deidre Ann Boatright, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT021642 Issued in PA

Practice address

1 Savannah Square Dr
Savannah, GA 31406-6755

Phone

(912) 503-2698

NPI assigned

Oct 27, 2011

Last updated

Feb 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1083990576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAVANNAH SQUARE DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314066755",
            "telephone_number": "912-503-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAVANNAH SQUARE DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314066755",
            "telephone_number": "912-503-2698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Vine St",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185102126",
            "country_code": "US",
            "telephone_number": "570-344-6177 x158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOATRIGHT",
        "first_name": "DEIDRE",
        "middle_name": "ANN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-27",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT021642",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blue and Gold Dental, LLC (Little Chompers Kids Dentistry)
• Haley Michelle Blumenstock, CRNP
• Joseph Daniel Boaen IV, M.D.
• Leroy Boards
• Carli A Boatright
• Julie Owens Boatright, PHARMD.
• Samuel Augustin Boatright
• Daniel A. Bochner, PSYD
• Henry Bochner
• Jayesh Bharat Bodalia, AA

• Physical Therapist in Savannah, GA
• Providers in Savannah, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.