NPIMap

Organization Active NPI

Caredoc LLC

  • Physical Medicine & Rehabilitation Physician
  • Gulfport, MS
National Provider Identifier
1306583505
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
CAREDOC LLC
Practice address
4500 13TH St
Gulfport, MS 39501-2515
Phone
(228) 265-1323
NPI assigned
May 18, 2022
Last updated
Sep 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Authorized official

Name
Nathan BolesNPI 1730277757
Title
Owner
Phone
(228) 236-3872

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
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

4500 13TH St
Gulfport, MS 39501-2515

Mailing address

1302 44TH Ave
Gulfport, MS 39501-2552
Phone (228) 236-3872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190109002502 MS Part B Supplier - Clinic/Group Practice 7719223957 Receives reassigned benefits from 30 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gulfport, MS

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Care Doc LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788825600000",
    "number": "1306583505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 44TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012552",
            "telephone_number": "228-236-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-265-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREDOC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-18",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A",
        "authorized_official_last_name": "BOLES",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-236-3872"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.