Patrick Nathan Boscaccy, A.T.,C. ; LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

874 Issued in TN

Practice address

3087 Professional PLZ
Germantown, TN 38138-7912

Phone

(901) 730-0681

Fax

(901) 730-0673

NPI assigned

Mar 15, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2565/brand/1/csg/1/fhir/r4

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.

• Southern Spine Specialists, PLLC

  • Orthopaedic Surgery of the Spine Physician
  • Collierville, TN
  • NPI 1417117433

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1689973711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W POPLAR AVE STE 201",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170601",
            "telephone_number": "901-730-0681",
            "fax_number": "901-730-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3087 PROFESSIONAL PLZ",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381387912",
            "telephone_number": "901-730-0681",
            "fax_number": "901-730-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSCACCY",
        "first_name": "PATRICK",
        "middle_name": "NATHAN",
        "name_prefix": "Mr.",
        "credential": "A.T.,C. ; LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-15",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Michael Bone
• Allison Elizabeth Boone, MD
• Rebecca Jean Borgman
• Brian James Borkowski, MD
• Phani Borra, M.D.
• Melissa R Bosserman, MSW, LCSW
• Barry Boston, MD
• Kaitlyn Caycee Bothwell
• Michele A Botnick, PTA
• Andrea Marie Boucher, DNP, MSN, CNM

• Athletic Trainer in Germantown, TN
• Providers in Germantown, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.