Mikaila E Boldt, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P22022 Issued in NC

Practice address

580 S Page St
Southern Pines, NC 28387-5837

Phone

(717) 673-2476

Fax

(888) 645-6068

NPI assigned

Mar 2, 2018

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

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Movementx, Inc.

  • Physical Therapist
  • Alexandria, VA
  • NPI 1851858054
  NPD

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1003318338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 SE TACOMA ST UNIT 122",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972026639",
            "telephone_number": "971-361-9442",
            "fax_number": "888-645-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 S PAGE ST",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875837",
            "telephone_number": "717-673-2476",
            "fax_number": "888-645-6068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "918 Cheyenne Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809052428",
            "country_code": "US",
            "telephone_number": "717-673-2476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLDT",
        "first_name": "MIKAILA",
        "middle_name": "E",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-02",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P22022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Gay Boado
• Joseph C Boals IV, M.D.
• Brooke Bodnar
• Peter Boghdadi, MS
• Markus Alexander Boin, M.D.
• Lydia Jane Bonecutter
• Katherine Bonilla
• Carol Borsman
• Olivia Bortz
• Taylor Michael Bosley, DO

• Physical Therapist in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.