NPIMap

Organization Active NPI

Kimberly Bolen, PLLC

  • Psychologist
  • Wilmington, NC
National Provider Identifier
1205274909
Registry record updated Jul 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3605 Issued in NC
Legal business name
KIMBERLY BOLEN, PLLC
Practice address
1213 Culbreth Dr
Suite 125
Wilmington, NC 28405-3639
Phone
(910) 509-7147
Fax
(910) 821-8447
NPI assigned
Jun 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2015

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

Authorized official

Name
Kimberly Bolen McGrew, MA, LPANPI 1467609743
Title
Psychologist
Phone
(910) 512-2890

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 3605 NC Primary

Addresses

Primary practice location

1213 Culbreth Dr
Suite 125
Wilmington, NC 28405-3639

Mailing address

7212 Culloden CT
Wilmington, NC 28411-7265
Phone (910) 512-2890

National Provider Directory

National Provider Directory

Locations

1213 Culbreth Dr
Ste 125
Wilmington, NC 28405
Phone (910) 509-7147

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436572800000",
    "number": "1205274909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 CULLODEN CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284117265",
            "telephone_number": "910-512-2890",
            "fax_number": "910-821-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 CULBRETH DR",
            "address_2": "SUITE 125",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053639",
            "telephone_number": "910-509-7147",
            "fax_number": "910-821-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY BOLEN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-05",
        "last_updated": "2015-07-11",
        "status": "A",
        "authorized_official_last_name": "MCGREW",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "BOLEN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "910-512-2890",
        "authorized_official_credential": "MA, LPA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2015; 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.