Nicole Bolden, PEER SUPPORT

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

APS005308 Issued in OH

Practice address

4977 Northcutt PL
Dayton, OH 45414-3839

Phone

(800) 829-5461

NPI assigned

Aug 12, 2024

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1073344008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9251 VAUGHN RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453424158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4977 NORTHCUTT PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143839",
            "telephone_number": "800-829-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "NICOLE",
        "credential": "PEER SUPPORT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS005308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John J Bohls
• Richard Kurt Alexander Bohme, DDS, FAGD
• Amy Sue Bokal, M.D.
• Krista D Bolanger, PA
• Chynne Kierra Bolden, LSW, MSW
• Tyrone Bolden
• Christopher Boldi, PHARM.D.
• Frederick Santi Boldi, CRNA
• Emily E Boldman, PA-C
• Devonee Bolds

• Peer Specialist in Dayton, OH
• Providers in Dayton, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.