Jonathan Craig Boydston, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW 1874 Issued in FL

Practice address

13936 Grover Rd.
Jacksonville, FL 32226-5063

Phone

(850) 855-8601

NPI assigned

Feb 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mr. J. Craig Boydston Professional name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bridgeway Center Inc

  • Community/Behavioral Health Agency
  • Fort Walton Beach, FL
  • NPI 1578677076

  Mental Health

  Medicare reassignment NPD
• Optum Behavioral Care of North Carolina, PC

  • Counseling Psychologist
  • Sarasota, FL
  • NPI 1033984448
  Medicare reassignment
• Bridgeway Center, Inc

  • General Practice Physician
  • Fort Walton Beach, FL
  • NPI 1174169080
  NPD
• Bridgeway Center Inc

  • Community/Behavioral Health Agency
  • Fort Walton Beach, FL
  • NPI 1568038222

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1629042080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13936 GROVER RD.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322265063",
            "telephone_number": "850-855-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13936 GROVER RD.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322265063",
            "telephone_number": "850-855-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYDSTON",
        "first_name": "JONATHAN",
        "middle_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 1874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "761910300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J.",
            "last_name": "BOYDSTON",
            "middle_name": "CRAIG",
            "prefix": "MR.",
            "credential": "L.C.S.W.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Glorianne Boyd, RD,LD/N
• Marjorie-Joi E Boyd
• Phillip Boyd
• Sarah C Boyd
• Danielle O'Connor Boyden, PA-C
• Alysia Boyer
• Beth Boyer, PA-C
• Jennifer J Boyer
• Shawana Boyer
• Victoria Boyer, BA

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.