Active NPI
Edythe Bolden
- Specialist
- Scottsboro, AL
National Provider Identifier
1255443214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 508 Gregory St
Scottsboro, AL 35768-4239 - Phone
- (256) 256-1774
- Fax
- (256) 259-0761
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
508 Gregory St
Scottsboro, AL 35768-4239
Mailing address
2003 Moody Ridge Rd
Scottsboro, AL 35768-2305
Phone (256) 259-3091
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marshall-Jackson Mental Health BD., Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Guntersville, AL
- NPI 1568495588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255443214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2003 MOODY RIDGE RD",
"city": "SCOTTSBORO",
"state": "AL",
"postal_code": "357682305",
"telephone_number": "256-259-3091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 GREGORY ST",
"city": "SCOTTSBORO",
"state": "AL",
"postal_code": "357684239",
"telephone_number": "256-256-1774",
"fax_number": "256-259-0761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDEN",
"first_name": "EDYTHE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsboro, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.