Active NPI
Jeffrey Dale Boyles, PT
- Physical Therapist
- Jasper, AL
National Provider Identifier
1396993689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH1573
- Practice address
- 4330 Highway 78 E
Suite 208
Jasper, AL 35501-8905 - Phone
- (205) 295-2434
- Fax
- (205) 384-6117
- NPI assigned
- Aug 29, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH1573 | AL | Primary |
Addresses
Primary practice location
4330 Highway 78 E
Suite 208
Jasper, AL 35501-8905
Mailing address
161 County Road 93
Haleyville, AL 35565-7248
Phone (205) 486-8473
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTH1573 | AL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219968000000",
"number": "1396993689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 COUNTY ROAD 93",
"city": "HALEYVILLE",
"state": "AL",
"postal_code": "355657248",
"telephone_number": "205-486-8473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4330 HIGHWAY 78 E",
"address_2": "SUITE 208",
"city": "JASPER",
"state": "AL",
"postal_code": "355018905",
"telephone_number": "205-295-2434",
"fax_number": "205-384-6117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYLES",
"first_name": "JEFFREY",
"middle_name": "DALE",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-29",
"last_updated": "2008-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH1573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jasper, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.