NPIMap

Individual provider Active NPI

Brent Edgeworth Boyett, DMD, DO

  • Family Medicine Physician
  • Hamilton, AL
National Provider Identifier
1235211129
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO654 Issued in AL
Practice address
2131 Military St S
Hamilton, AL 35570-6651
Phone
(205) 921-5556
Fax
(205) 921-5595
NPI assigned
Oct 19, 2006
Last updated
Aug 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4622 AL
Family Medicine Physician 207Q00000X DO654 AL Primary

Addresses

Primary practice location

2131 Military St S
Hamilton, AL 35570-6651

Mailing address

2131 Military St S
Hamilton, AL 35570-6651
Phone (205) 921-0893

Other identifiers 1

IdentifierTypeStateIssuer
009981160MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040505001712 AL Practitioner - PsychiatryPractitioner - Emergency MedicinePractitioner - General PracticePractitioner - Family Practice 2668460759 Reassigns benefits to 2 organizations
I20051121000774 MS Practitioner - Family PracticePractitioner - Emergency Medicine 2668460759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3302 W Linden St
Suite a
Corinth, MS 38834-9119
Phone (662) 331-1956

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO654ALMDFamily Medicine Physician
4622ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of North Central Alabama Inc. CurrentSince Apr 12, 2024 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jun 26, 2021 Accepting new patients
App of Alabama Ed PLLC CurrentSince Jan 27, 2013 Accepting new patients
Marion Regional Medical Center, Inc. CurrentSince Sep 20, 2001 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Marion Regional Medical Center, Inc CurrentSince Sep 20, 2001 Accepting new patients
Pathway Healthcare-Louisiana, LLC Past Accepting new patients

Locations

83825 Highway 9
Ashland, AL 36251
Phone (256) 354-1195

1316 Somerville Rd SE
Ste 1
Decatur, AL 35601
Phone (256) 260-7361

4110 US Highway 31 S
Decatur, AL 35603
Phone (256) 260-7360

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

1256 Military St S
Hamilton, AL 35570
Phone (205) 921-6200

1336 Military St S
Hamilton, AL 35570
Phone (205) 921-0521

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

3302 W Linden St
#A
Corinth, MS 38834
Phone (662) 331-1956

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: brentboyett@nmhs.medalliesdirect.net

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1235211129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 MILITARY ST S",
            "city": "HAMILTON",
            "state": "AL",
            "postal_code": "355706651",
            "telephone_number": "205-921-0893",
            "fax_number": "205-921-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 MILITARY ST S",
            "city": "HAMILTON",
            "state": "AL",
            "postal_code": "355706651",
            "telephone_number": "205-921-5556",
            "fax_number": "205-921-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYETT",
        "first_name": "BRENT",
        "middle_name": "EDGEWORTH",
        "credential": "DMD, DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4622",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009981160",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, AL

Sources for this page

Verify at the official NPI Registry.