Adelyn Grace Bolton

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

205 Peach Orchard Rd
Baldwin, GA 30511-1803

Phone

(706) 778-8377

NPI assigned

Jan 11, 2025

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

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

{
    "created_epoch": "1736553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1104636067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 CHIMNEY VIEW RD",
            "city": "SAUTEE NACOOCHEE",
            "state": "GA",
            "postal_code": "305711870",
            "telephone_number": "706-969-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PEACH ORCHARD RD",
            "city": "BALDWIN",
            "state": "GA",
            "postal_code": "305111803",
            "telephone_number": "706-778-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "ADELYN",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-11",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrick Keith Bailey, MD
• Baldwin Pharmacy LLC
• Baldwin Pharmacy LLC
• Maureen Burnham
• Amy Beck Conner, CPNP-PC
• Thomas Jordan Crow, PHARMD
• Nicole Crumley, PA-C
• Christy A Floyd, R.N., CPNP-PC

• All providers in Baldwin, GA
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; 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.