Active NPI
Your PT at Home
- Physical Therapist
- Richmond Hill, GA
National Provider Identifier
1669191581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- YOUR PT AT HOME
- Practice address
- 105 Maxwell CT
Richmond Hill, GA 31324 - Phone
- (912) 572-7054
- Fax
- (917) 746-1223
- NPI assigned
- Aug 24, 2022
- Last updated
- Aug 24, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bryan Charles Bost, PT, DSC
- Title
- Ceo
- Phone
- (912) 572-7054
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary |
Addresses
Primary practice location
105 Maxwell CT
Richmond Hill, GA 31324
Mailing address
60 Exchange St Ste C3
Richmond Hill, GA 31324-7647
Phone (912) 572-7054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
60 Exchange St
Ste C3
Richmond Hill, GA 31324
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661299200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1661299200000",
"number": "1669191581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 EXCHANGE ST STE C3",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "313247647",
"telephone_number": "912-572-7054",
"fax_number": "917-746-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 MAXWELL CT",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "31324",
"telephone_number": "912-572-7054",
"fax_number": "917-746-1223"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YOUR PT AT HOME",
"organizational_subpart": "NO",
"enumeration_date": "2022-08-24",
"last_updated": "2022-08-24",
"certification_date": "2022-08-18",
"status": "A",
"authorized_official_last_name": "BOST",
"authorized_official_first_name": "BRYAN",
"authorized_official_middle_name": "CHARLES",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "912-572-7054",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PT, DSC"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Richmond Hill, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.