Dr Judy Polo Boshart

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4410 Issued in OK

Legal business name

DR JUDY POLO BOSHART

Practice address

1601 S Adams St
Fort Worth, TX 76104-4410

Phone

(281) 660-9288

NPI assigned

Jun 30, 2015

Organization subpart

No

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

Authorized official

Name

Judy Boshart, PH D CCC-SLPNPI 1972675254

Title

Owner

Phone

(281) 660-9288

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judy P Boshart, MS CCCSLP

  • Speech-Language Pathologist
  • Fort Worth, TX
  • NPI 1972675254
  NPD Authorized official

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1124401864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 S ADAMS ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044410",
            "telephone_number": "281-660-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S ADAMS ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044410",
            "telephone_number": "281-660-9288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2224 Mission Rd",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730346825",
            "country_code": "US",
            "telephone_number": "281-660-9288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR JUDY POLO BOSHART",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "BOSHART",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-660-9288",
        "authorized_official_credential": "PH D CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208971601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.