Individual provider Active NPI

Margene Bolingbroke

  • Speech-Language Assistant
  • Winfield, MO
National Provider Identifier
1275306268
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
2023016023 Issued in MO
Practice address
100 8TH St
Winfield, MO 63389-1170
Phone
(636) 668-8188
NPI assigned
Nov 1, 2023
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 2023016023 MO Primary

Addresses

Primary practice location

100 8TH St
Winfield, MO 63389-1170

Mailing address

100 8TH St
Winfield, MO 63389-1170

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

State licenses

LicenseStateTypeSpecialty
2023016023MOMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1275306268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 8TH ST",
            "city": "WINFIELD",
            "state": "MO",
            "postal_code": "633891170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 8TH ST",
            "city": "WINFIELD",
            "state": "MO",
            "postal_code": "633891170",
            "telephone_number": "636-668-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLINGBROKE",
        "first_name": "MARGENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "MO",
            "license": "2023016023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.