Zachary Boyle, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2016003391 Issued in MO

Practice address

15425 Manchester Rd
Suite 28
Ballwin, MO 63011-3077

Phone

(636) 220-6969

NPI assigned

Feb 14, 2017

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

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bespoke Physical Therapy, Wellness and PerformanceGroup PAC ID 5294203428, 2 clinicians

Practice addresses (Care Compare)

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.

• Bespoke Physical Therapy, Wellness and Performance

  • Physical Therapist
  • Wildwood, MO
  • NPI 1508715756

  MO

  Medicare reassignment Care Compare group
• Central Missouri Physical Therapy LLC

  • Physical Therapist
  • Columbia, MO
  • NPI 1558436592
  NPD

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1710426432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15425 MANCHESTER RD",
            "address_2": "STE 28",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113077",
            "telephone_number": "636-220-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15425 MANCHESTER RD",
            "address_2": "SUITE 28",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113077",
            "telephone_number": "636-220-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "ZACHARY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2016003391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James S. Bonner, M.D.
• Marie A Bosch, MD
• Amelia Helen Bottcher
• Kaitlyn Ann Bowen, LAT, ATC
• Jennifer Bowers, LPC
• Brandon Prior DMD LLC
• Brassie Chiropractic LLC
• Joel Andrew Brassie, D.C.
• Alexandra Bratton, RBT
• Kyle Robert Brennan, PHARM.D,

• Physical Therapist in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.