Dominic Jaren Bolton, CSCS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

101 N College Ave
Annville, PA 17003-1404

Phone

(301) 331-5830

NPI assigned

Oct 7, 2026

Last updated

Oct 7, 2026By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1791331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1063316578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N COLLEGE AVE",
            "city": "ANNVILLE",
            "state": "PA",
            "postal_code": "170031404",
            "telephone_number": "301-331-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N COLLEGE AVE",
            "city": "ANNVILLE",
            "state": "PA",
            "postal_code": "170031404",
            "telephone_number": "301-331-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "DOMINIC",
        "middle_name": "JAREN",
        "credential": "CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-07",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.