Caroline M Bolton, PHYSICAL THERAPIST
Individual provider Active NPI Physical Therapist · Jackson, TN
NPI 1104949353 · NPPES record last updated May 27, 2009
Key facts
- NPI
- 1104949353
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT0000004486 (TN)
- Practice address
- 569 Skyline Dr
Suite 100
Jackson, TN 38301-3911 - Phone
- (731) 427-7888
- Fax
- (731) 265-4152
- NPI assigned
- Apr 10, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Noma PC
Practice addresses (Care Compare)
111 Stonebridge Blvd
Jackson, TN 38305-2040
Phone (731) 427-7888
Merit-based Incentive Payment System (MIPS)
- Final score
- 68.9 of 100
- Quality
- 45.42
- Promoting interoperability
- 75
- Improvement activities
- 40
- Cost
- 71.75
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060405000655 | TN | Practitioner - Physical Therapist in Private Practice | 1355350158 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT0000004486 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Noma, PC | Current |
Accepting new patients | |
| Carl W. Huff, MD, PC | Past | Accepting new patients |
Locations
569 Skyline Dr
Ste 100
Jackson, TN 38301
Phone (731) 427-7888
111 Stonebridge Blvd
Jackson, TN 38305
Phone (731) 410-6777
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- caroline.boltonptatc.p1@direct.sportsorthospine.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT0000004486 | TN | Yes |
Addresses
Primary practice location
569 Skyline Dr
Suite 100
Jackson, TN 38301-3911
Mailing address
569 Skyline Dr
Suite 100
Jackson, TN 38301-3911
Phone (731) 427-7888
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3709355 | Medicaid | TN |
Other providers in Jackson, TN
- Billie Sue Blythe
- Sandra Bobbitt
- Carson Bodiford
- Gregory Lee Bohner
- Roger Boleyn
- Mary June Bolton
- Melissa L Bolton
- Acunda Bond
- Angela Bond
- Elias K Bond
All providers in Jackson, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.