Ansley Walker Boutin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P7648 Issued in NC

Practice address

10305 Hamptons Park Dr Ste 101
Huntersville, NC 28078-7221

Phone

(704) 384-5520

Fax

(704) 316-1848

NPI assigned

Nov 10, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ansley Elizabeth Walker Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: aboutin79110@direct.novanthealth.org

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.

• Foundation Health Systems LLC

  • Physical Therapy Clinic/Center
  • Winston Salem, NC
  • NPI 1205894029

  Physical Therapist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1104222785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-5520",
            "fax_number": "704-316-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10305 HAMPTONS PARK DR STE 101",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787221",
            "telephone_number": "704-384-5520",
            "fax_number": "704-316-1848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10030 Gilead Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787545",
            "country_code": "US",
            "telephone_number": "704-316-5505",
            "fax_number": "704-316-5520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUTIN",
        "first_name": "ANSLEY",
        "middle_name": "WALKER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-10",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "7648",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P7648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aboutin79110@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "10030 Gilead Rd Ste 103",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280787545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANSLEY",
            "last_name": "WALKER",
            "middle_name": "ELIZABETH",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Grace Boone, PT, DPT
• Kaylie Booth
• Jason Adrian Boothe, MD
• Jayda Boston
• Jeanette Lillian Bourne, MD
• Amanda Brooks Bowen, PA-C
• Anastasia Bowman, PT, DPT
• Christian Bowman, SLP
• Elizabeth Ann Boyd, LCMHC
• Emily Graham Boyd, AU.D.

• Physical Therapist in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.