Active NPI
Travis Ryan Boyette, OTR
- Occupational Therapist
- Scottsdale, AZ
National Provider Identifier
1497818140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3402
- Practice address
- 4016 N 78TH St
Scottsdale, AZ 85251-4640 - Phone
- (480) 246-4040
- NPI assigned
- Dec 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3402 | AZ | Primary |
| Occupational Therapist | 225X00000X | 9576 | MA | |
| Occupational Therapist | 225X00000X | 2607 | GA |
Addresses
Primary practice location
4016 N 78TH St
Scottsdale, AZ 85251-4640
Mailing address
4016 N 78TH St
Scottsdale, AZ 85251-4640
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9576 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228780800000",
"number": "1497818140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4016 N 78TH ST",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852514640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4016 N 78TH ST",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852514640",
"telephone_number": "480-246-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYETTE",
"first_name": "TRAVIS",
"middle_name": "RYAN",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-17",
"last_updated": "2008-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "3402",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "9576",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "2607",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.