Individual provider Active NPI

William Leighton Boatwright, PTA

  • Physical Therapy Assistant
  • Cary, NC
National Provider Identifier
1407648694
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A8605 Issued in NC
Practice address
111 James Jackson Ave Ste 101
Cary, NC 27513-3598
Phone
(919) 651-0050
NPI assigned
May 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A8605 NC Primary

Addresses

Primary practice location

111 James Jackson Ave Ste 101
Cary, NC 27513-3598

Mailing address

548 Morning Light Dr
Angier, NC 27501-6359
Phone (321) 652-7155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250725002227 NC Practitioner - Physical Therapist in Private Practice 8224545298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A8605NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
HH1 CurrentSince Jun 1, 2025 Accepting new patients

Locations

111 James Jackson Ave
Ste 101
Cary, NC 27513
Phone (919) 651-0050

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1407648694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 MORNING LIGHT DR",
            "city": "ANGIER",
            "state": "NC",
            "postal_code": "275016359",
            "telephone_number": "321-652-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 JAMES JACKSON AVE STE 101",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133598",
            "telephone_number": "919-651-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATWRIGHT",
        "first_name": "WILLIAM",
        "middle_name": "LEIGHTON",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A8605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.