Individual provider Active NPI

Jacob Griffith Bouslough, PT

  • Physical Therapist
  • York, PA
National Provider Identifier
1972328789
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT32811 Issued in PA
Practice address
1855 Powder Mill Rd
York, PA 17402-4723
Phone
(717) 747-8302
NPI assigned
Nov 18, 2024
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT32811 PA Primary

Addresses

Primary practice location

1855 Powder Mill Rd
York, PA 17402-4723

Mailing address

1855 Powder Mill Rd
York, PA 17402-4723
Phone (717) 747-8302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250121000065 PA Practitioner - Physical Therapist in Private Practice 1658800735 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT32811PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oss Orthopaedic Hospital, LLC CurrentSince Nov 7, 2024 Accepting new patients
Oss Orthopaedic Hospital, LLC CurrentSince Nov 7, 2024 Accepting new patients

Locations

470 Eisenhower Dr
Hanover, PA 17331
Phone (717) 633-0031

1861 Powder Mill Rd
York, PA 17402
Phone (717) 718-2000

1855 Powder Mill Rd
York, PA 17402

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": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1972328789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 POWDER MILL RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174024723",
            "telephone_number": "717-747-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 POWDER MILL RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174024723",
            "telephone_number": "717-747-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSLOUGH",
        "first_name": "JACOB",
        "middle_name": "GRIFFITH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT32811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.