Taylor Jack Helmboldt

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

920 Madison Ave
Memphis, TN 38103-3438

Phone

(901) 448-5500

NPI assigned

Mar 27, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mr. Taylor Jack Boldt Professional name

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": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1124820105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 BUBBY DR",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380171025",
            "telephone_number": "865-803-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033438",
            "telephone_number": "901-448-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELMBOLDT",
        "first_name": "TAYLOR",
        "middle_name": "JACK",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "BOLDT",
            "middle_name": "JACK",
            "prefix": "MR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Student in an Organized Health Care Education/Training Program in Memphis, TN
• Providers in Memphis, TN by specialty
• Student in an Organized Health Care Education/Training Program in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.