NPIMap

Individual provider Active NPI

Boyd Michael Minnich, PT

  • Physical Therapist
  • Morristown, TN
National Provider Identifier
1528044864
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0000000751 Issued in TN
Practice address
420 W Morris Blvd
Ste 180
Morristown, TN 37813-2283
Phone
(423) 586-6866
Fax
(423) 581-9679
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0000000751 TN Primary

Addresses

Primary practice location

420 W Morris Blvd
Ste 180
Morristown, TN 37813-2283

Mailing address

420 W Morris Blvd
Ste 180
Morristown, TN 37813-2283
Phone (423) 586-6866

Other identifiers 2

IdentifierTypeStateIssuer
0101380OtherTNBLUE CROSS BLUE SHIELD
3651249MedicaidTN

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

LicenseStateTypeSpecialty
0000000751TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Compwhiz International LLC Physical Therapist Past Accepting new patients
East Tennessee Comprehensive Rehabilitation Center Inc Physical Therapist Past Accepting new patients
Hamblen Therapy Associates, Inc Physical Therapist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1528044864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W MORRIS BLVD",
            "address_2": "STE 180",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132283",
            "telephone_number": "423-586-6866",
            "fax_number": "423-581-9679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MORRIS BLVD",
            "address_2": "STE 180",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132283",
            "telephone_number": "423-586-6866",
            "fax_number": "423-581-9679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICH",
        "first_name": "BOYD",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "0000000751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0101380",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3651249",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.

Verify at the official NPI Registry.