Individual provider Active NPI

Patricia L Boyst, CRNP

  • Pediatric Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1720006901
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R090893 Issued in MD
Practice address
324 E Antietam St
Suite 301
Hagerstown, MD 21740-5754
Phone
(301) 791-6666
Fax
(301) 791-4549
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R090893 MD Primary

Addresses

Primary practice location

324 E Antietam St
Suite 301
Hagerstown, MD 21740-5754

Mailing address

324 E Antietam St
Suite 301
Hagerstown, MD 21740-5754
Phone (301) 791-6666

Other identifiers 1

IdentifierTypeStateIssuer
149091500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R090893MDMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720006901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST",
            "address_2": "SUITE 301",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405754",
            "telephone_number": "301-791-6666",
            "fax_number": "301-791-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST",
            "address_2": "SUITE 301",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405754",
            "telephone_number": "301-791-6666",
            "fax_number": "301-791-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYST",
        "first_name": "PATRICIA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R090893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149091500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.