John I Boswell III, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

035090-E Issued in PA

Practice address

1315 W College Ave
Suite 303
State College, PA 16801-2776

Phone

(814) 861-3300

NPI assigned

Jun 30, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Universal Community Behavioral Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Huntingdon, PA
  • NPI 1659384436
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1720085228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 W COLLEGE AVE",
            "address_2": "SUITE 303",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012776",
            "telephone_number": "814-861-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 W COLLEGE AVE",
            "address_2": "SUITE 303",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012776",
            "telephone_number": "814-861-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSWELL",
        "first_name": "JOHN",
        "middle_name": "I",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "035090-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010576160010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Lee Bonsell, PHARMD
• Roberta Jean Boob, PTA
• Sarah E Bork, MD
• Philip J. Bosha, M.D.
• Jake Ryan Bostick, PT
• Joshua Randel Botteicher
• Phillip Donald Bottenfield
• Kasandra Ann Botti, D.O.
• Ashley Marie Bowser, PA-C
• Paula Lyn Boyer, MSW

• Child & Adolescent Psychiatry Physician in State College, PA
• Providers in State College, PA by specialty
• Child & Adolescent Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.