Active NPI
Nikki Marie Boles, LMT
- Massage Therapist
- Grants Pass, OR
National Provider Identifier
1053853861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 22456
- Practice address
- 220 SE H St
#5B
Grants Pass, OR 97526-3025 - Phone
- (541) 787-1200
- NPI assigned
- Nov 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 22456 | OR | Primary |
Addresses
Primary practice location
220 SE H St
#5B
Grants Pass, OR 97526-3025
Mailing address
220 SE H St
#5B
Grants Pass, OR 97526-3025
Phone (541) 787-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22456 | OR | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mec Disabilities | Massage Therapist | Current | Accepting new patients |
Organizations & group practices 1
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": "1478736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478736000000",
"number": "1053853861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 SE H ST",
"address_2": "#5B",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975263025",
"telephone_number": "541-787-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 SE H ST",
"address_2": "#5B",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975263025",
"telephone_number": "541-787-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLES",
"first_name": "NIKKI",
"middle_name": "MARIE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-10",
"last_updated": "2016-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "22456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.