Individual provider Active NPI

Dennis Hoyt Boswell, PA

  • Physician Assistant
  • Peachtree City, GA
National Provider Identifier
1275784373
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002742 Issued in GA
Practice address
1401 Georgian Park Ste 200
Peachtree City, GA 30269-6974
Phone
(770) 632-8909
NPI assigned
Oct 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002742 GA Primary

Addresses

Primary practice location

1401 Georgian Park Ste 200
Peachtree City, GA 30269-6974

Mailing address

119 Ambulance Dr
Suite 202
Carrollton, GA 30117-3857
Phone (770) 838-8710

Other practice location 1

1125 E Highway 166
Bowdon, GA 30108-2401
Phone (770) 258-5424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110823001063 GA Practitioner - Physician Assistant 9739248790 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

1401 Georgian Park
Suite 200
Peachtree City, GA 30269-6974
Phone (770) 632-8909

Hospital & facility affiliations

  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002742GAMDPhysician Assistant

Organizations & group practices 3

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.

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": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1275784373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR",
            "address_2": "SUITE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-838-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 GEORGIAN PARK STE 200",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696974",
            "telephone_number": "770-632-8909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 E Highway 166",
            "address_purpose": "LOCATION",
            "city": "Bowdon",
            "state": "GA",
            "postal_code": "301082401",
            "country_code": "US",
            "telephone_number": "770-258-5424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSWELL",
        "first_name": "DENNIS",
        "middle_name": "HOYT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

Verify at the official NPI Registry.