Brian Joseph Boyle, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8975 Issued in NC

Practice address

128 Speedway Dr
Mooresville, NC 28117-6879

Phone

(704) 768-1013

Fax

(704) 264-0711

NPI assigned

Jul 27, 2005

Last updated

Oct 8, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Athelite Physical Performance Center of Lake Norman, LLC

  dba AthElite PPC

  • Physical Therapist
  • Statesville, NC
  • NPI 1669772802
  Authorized official Same address or phone
• Gaston Rehab Associates, Inc

  • Physical Therapy Clinic/Center
  • Gastonia, NC
  • NPI 1124028758
  NPD (past) Authorized official

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1629078159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "LOWELL",
            "state": "NC",
            "postal_code": "280980069",
            "telephone_number": "704-241-0889",
            "fax_number": "704-864-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 SPEEDWAY DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176879",
            "telephone_number": "704-768-1013",
            "fax_number": "704-264-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7559538",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D3291",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3484600",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "078V2",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211587",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Clyde Bowes III, D.C.
• Kirstyn Bowman
• Dennekie Boyd
• Renee Boyer, PHARMD
• Patrice Boykin
• Brian M Bradigan, LCASA
• Christopher Bradley, PA-C
• Steven H Bradley, MD
• Christopher Brady, PHARM.D.
• Nicole Brady

• Physical Therapist in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.