Active NPI
Howard Thomas Bosworth, PSY.D.
- Psychologist
- Winston Salem, NC
National Provider Identifier
1780901926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1201
- Practice address
- 1304 Ashley Square
Winston Salem, NC 27103 - Phone
- (336) 768-8995
- Fax
- (336) 768-7129
- NPI assigned
- Apr 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1201 | NC | Primary |
Addresses
Primary practice location
1304 Ashley Square
Winston Salem, NC 27103
Mailing address
1304 Ashley Square
Winston Salem, NC 27103
Phone (336) 768-8995
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1201 | NC | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272412800000",
"number": "1780901926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1304 ASHLEY SQUARE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "27103",
"telephone_number": "336-768-8995",
"fax_number": "336-768-7129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 ASHLEY SQUARE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "27103",
"telephone_number": "336-768-8995",
"fax_number": "336-768-7129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSWORTH",
"first_name": "HOWARD",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-28",
"last_updated": "2010-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "1201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.