Boland Prosthetic & Orthotic Center LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

NO STATE LICENSURE Issued in GA

Legal business name

BOLAND PROSTHETIC & ORTHOTIC CENTER LLC

Practice address

110 Osigian Blvd.
Warner Robins, GA 31088

Phone

(478) 953-2922

Fax

(478) 953-2927

NPI assigned

Sep 29, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Paul A Boland, CPO

Title

Owner, Orthotist/Prosthetist

Phone

(478) 953-2922

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1164419743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 OSIGIAN BLVD.",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-953-2922",
            "fax_number": "478-953-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 OSIGIAN BLVD.",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-953-2922",
            "fax_number": "478-953-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLAND PROSTHETIC & ORTHOTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "BOLAND",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER, ORTHOTIST/PROSTHETIST",
        "authorized_official_telephone_number": "478-953-2922",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "GA",
            "license": "NO STATE LICENSURE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00820751A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00820751B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly T. Blevens, MD
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• Eric Bock
• John Bocock
• Alexandra Bohner, LCSW
• Paul A Boland, CPO
• Delana Alicia Bongiovanni, NP-C
• Zoeb Bootwala, MD
• Debra Borden
• Hui Bostian

• Prosthetic/Orthotic Supplier in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.