Michele Diane Borst, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT008488 Issued in GA

Practice address

2601A Demere Rd
St Simons Island, GA 31522-1614

Phone

(912) 634-9945

Fax

(912) 638-1584

NPI assigned

Feb 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in VA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pt2Go, LLC

  dba Pt2go

  • Physical Therapist
  • VA BCH, VA
  • NPI 1639636517
  Medicare reassignment NPD
• Vim LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1083480651
  NPD

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811031206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601A DEMERE RD",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221614",
            "telephone_number": "912-634-9945",
            "fax_number": "912-638-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601A DEMERE RD",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221614",
            "telephone_number": "912-634-9945",
            "fax_number": "912-638-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORST",
        "first_name": "MICHELE",
        "middle_name": "DIANE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE NUMBER",
            "identifier": "PT008488",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louis Anthony Barton, MD
• Belinda Burroughs, Inc.
• Howard A Berg, DC
• Billy Jacob Blackmon, MD
• Edward Bolt
• Diane Gwyn Bowen, M.D.
• Nancy Hodges Bowen, FNP-C
• Robert W Bowen, M.D.
• Kevin D Boyer, D.M.D.
• Jacqueline Diane Braga

• Physical Therapist in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Physical Therapist in Georgia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.