Individual provider Active NPI

William Boydston, MD

  • Neurological Surgery Physician
  • Atlanta, GA
National Provider Identifier
1891749925
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
34112 Issued in GA
Practice address
5461 Meridian Mark Rd Ste 520
Atlanta, GA 30342-3283
Phone
(404) 785-2900
Fax
(404) 785-2930
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 34112 GA Primary

Addresses

Primary practice location

5461 Meridian Mark Rd Ste 520
Atlanta, GA 30342-3283

Mailing address

5461 Meridian Mark Rd Ste 520
Atlanta, GA 30342-3283
Phone (404) 785-2900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160309001297 GA Practitioner - Neurosurgery 2365520210 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34112GAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Neurosurgery Associates at Children'S, LLC Neurological Surgery CurrentSince Jan 1, 2016 Accepting new patients
Scottish Rite Childrens Medical Ctr Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Scottish Rite Children'S Medical Center Past Accepting new patients

Locations

1500 Oglethorpe Ave
Bldg 600EF
Athens, GA 30606

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

5461 Meridian Mark Rd
Ste 520
Sandy Springs, GA 30342
Phone (404) 785-2900

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

5461 Meridian Mark Rd
Ste 540
Sandy Springs, GA 30342
Phone (404) 255-6309

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

Interoperability endpoints

  • Direct secure messaging: wboydston1788@choa.gadirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1891749925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 520",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423283",
            "telephone_number": "404-785-2900",
            "fax_number": "404-785-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 520",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423283",
            "telephone_number": "404-785-2900",
            "fax_number": "404-785-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYDSTON",
        "first_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "34112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "5461 Meridian Mark Rd Ste 520",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303423283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.