Individual provider Active NPI

Thomas Scott Boatright, DMD

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1912014408
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7476 Issued in KY
Practice address
3800 Springhurst Blvd
Louisville, KY 40241-6138
Phone
(502) 339-7707
Fax
(502) 339-7760
NPI assigned
Aug 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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
General Practice Dentistry 1223G0001X 7476 KY Primary

Addresses

Primary practice location

3800 Springhurst Blvd
Louisville, KY 40241-6138

Mailing address

11708 Main St
Louisville, KY 40243-1426
Phone (502) 245-8627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160517002085 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517145121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7476KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Periodontic & Endodontic Services Past Accepting new patients
Mortenson Family Dental Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912014408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11708 MAIN ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431426",
            "telephone_number": "502-245-8627",
            "fax_number": "502-245-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SPRINGHURST BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402416138",
            "telephone_number": "502-339-7707",
            "fax_number": "502-339-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATRIGHT",
        "first_name": "THOMAS",
        "middle_name": "SCOTT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.