Benjamin Samuel Boyd, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

27777 Issued in CA

Practice address

1900 Powell St
Ste 6079
Emeryville, CA 94608-1811

Phone

(510) 593-7062

Fax

(510) 336-2654

NPI assigned

Aug 11, 2011

Last updated

Apr 5, 2017By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1679852420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 LITTLE LN",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945232178",
            "telephone_number": "510-869-6511",
            "fax_number": "510-869-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 POWELL ST",
            "address_2": "STE 6079",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081811",
            "telephone_number": "510-593-7062",
            "fax_number": "510-336-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "BENJAMIN",
        "middle_name": "SAMUEL",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-11",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "27777",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "27777",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "27777",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "FM306Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khaliyah Em Bolden
• Sherricia Bonds
• Mikaela Ashley Encontro Bongcaron
• Benjamin David Boodt, MD
• Haydee Antonia Bowden, BCBA
• Carolina Bracamonte-Espinoza
• Charita Bradshaw
• Lucky Abdullah Braimah
• Nicole Marie Braxley, MD
• Michael Brazelton, PA-C

• Physical Therapist in Emeryville, CA
• Providers in Emeryville, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.