Jacob William Boyd, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2014 Issued in SC

Practice address

4368 Spa Dr
Unit 407
Little River, SC 29566-5004

Phone

(843) 650-2213

NPI assigned

Sep 30, 2010

Last updated

Sep 30, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1245549898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4368 SPA DR",
            "address_2": "UNIT 407",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295665003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4368 SPA DR",
            "address_2": "UNIT 407",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295665004",
            "telephone_number": "843-650-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "JACOB",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "2014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Little River, SC
• Providers in Little River, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.