Active NPI
Bruce Ryland Boynton, M.D.
- Neonatal-Perinatal Medicine Physician
- Baltimore, MD
National Provider Identifier
1235315581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 19580
- Practice address
- 4209 Newgate Ave
Canton Pier 11
Baltimore, MD 21224-6416 - Phone
- (410) 631-7465
- Fax
- (410) 631-7467
- NPI assigned
- Jan 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 19580 | KY | Primary |
Addresses
Primary practice location
4209 Newgate Ave
Canton Pier 11
Baltimore, MD 21224-6416
Mailing address
10418 Hampton Rd
Fairfax Station, VA 22039-2757
Phone (703) 543-6554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19580 | KY | MD | Neonatal-Perinatal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1235315581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10418 HAMPTON RD",
"city": "FAIRFAX STATION",
"state": "VA",
"postal_code": "220392757",
"telephone_number": "703-543-6554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4209 NEWGATE AVE",
"address_2": "CANTON PIER 11",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212246416",
"telephone_number": "410-631-7465",
"fax_number": "410-631-7467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYNTON",
"first_name": "BRUCE",
"middle_name": "RYLAND",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-17",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "KY",
"license": "19580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.