Nicole Suzanne Bolda I, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05004492A Issued in IN

Practice address

329 W 84TH Dr
Merrillville, IN 46410-6245

Phone

(219) 791-9021

Fax

(219) 791-9022

NPI assigned

Jul 27, 2006

Last updated

Nov 27, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nicole Suzanne Kirn Former name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletic and Therapeutic Institute of Naperville, LLCGroup PAC ID 8325014020, 251 clinicians

Bone and Joint Specialists, P.C.Group PAC ID 8820018583, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.bolda.1@22358.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Athletic and Therapeutic Institute of Naperville, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Hammond, IN
  • NPI 1023313194
  Medicare reassignment Care Compare group NPD
• Bone & Joint Specialists, PC

  • Orthopaedic Surgery Physician
  • Merrillville, IN
  • NPI 1629083076

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Athletic and Therapeutic Institute of Naperville LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Aurora, IL
  • NPI 1023129681
  NPD
• Athletic and Therapeutic Institute of Naperville, LLC

  • Durable Medical Equipment & Medical Supplies
  • Hazel Crest, IL
  • NPI 1043952641
  NPD
• Orthopaedic Specialists of Northwest Indiana PC

  • Orthopaedic Surgery Physician
  • Munster, IN
  • NPI 1497865794
  NPD (past)
• Centers for Hand & Physical Rehabilitation, Inc.

  dba Motion Hand & Physical Therapy

  • Hand Occupational Therapist
  • Orland Park, IL
  • NPI 1386736130

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1255355780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 W 84TH DR",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106245",
            "telephone_number": "219-791-9021",
            "fax_number": "219-791-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDA",
        "first_name": "NICOLE",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05004492A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070008573",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "KIRN",
            "middle_name": "SUZANNE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Casey Bodak
• Body Opulence Therapy and Performance (Opulent Rehab Services)
• Jasmine Rae-Nicole Boesel
• Ashley Bohling, PA-C
• Bonnie Jo Boise, MA, CCC-SLP/L
• Shona Bolden, LMHCA
• Bone & Joint Specialists, PC
• Bone & Joint Specialists, PC
• James F Bonick, D.D.S.
• Virginia Bonilla, O.D.

• Physical Therapist in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.