Jean Boller, M.S.,CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

50862 Issued in TX

Practice address

603 E Hildebrand Ave
San Antonio, TX 78212-2693

Phone

(210) 824-0063

Fax

(210) 824-8514

NPI assigned

Oct 13, 2005

Last updated

Sep 30, 2014By 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 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Sunshine Cottage School for Deaf Children

  • Audiologist-Hearing Aid Fitter
  • San Antonio, TX
  • NPI 1386808459
  NPD (past)

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1306834221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 E HILDEBRAND AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122693",
            "telephone_number": "210-824-0063",
            "fax_number": "210-824-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E HILDEBRAND AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122693",
            "telephone_number": "210-824-0063",
            "fax_number": "210-824-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLER",
        "first_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "M.S.,CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "50862",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "50862",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "TX",
            "license": "50862",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151653604",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEARING AID DISPENSING",
            "identifier": "90166",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "50862",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David H Boldt, M.D.
• Carlee C Boles, DDS
• Brandon L Bolfing, MD
• Sharon Jude Bolin, LCSW
• Leocarina Bolivar
• Christine Bollom, DNP, APRN, FNP-BC
• Teresa Suzanne Bolser
• Ashley Patricia Bolton
• Dawson Gregory Bolus, MD
• Everett Arthur Bolz, M.D.

• Audiologist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Audiologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.