Destiny Bolden, ND, RN

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

263319 Issued in NC

Practice address

964 High House Rd # 2017
Cary, NC 27513-3574

Phone

(504) 345-8657

NPI assigned

Nov 18, 2011

Last updated

Apr 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 15

Addresses

Other names 1

• Beyond Bold Health Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1316214414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 HIGH HOUSE RD # 2017",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 HIGH HOUSE RD # 2017",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133574",
            "telephone_number": "504-345-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "DESTINY",
        "name_prefix": "Dr.",
        "credential": "ND, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "73285",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NC",
            "license": "263319",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NC",
            "license": "263319",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NC",
            "license": "263319",
            "primary": false
        },
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "NC",
            "license": "263319",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "DC",
            "license": "NAT1000727",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "263319",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "263319",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dbolden@beyondboldhealth.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "964 High House Rd # 2017",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275133574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BEYOND BOLD",
            "last_name": "HEALTH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Madison Bogdash, MS CCC-SLP
• Dasha Tiarra Boger
• Tory Michelle Boger
• James D. Bohn III, D.M.D.
• Julie Boice, FNP-BC
• Hayley Bolen
• Rielly Danielle Bolen
• Nadea Christina Rose Boles
• Bolick Counseling Services, PLLC
• Jeanne Latimer Bolick, LCSW

• Internal Medicine Physician in Cary, NC
• Providers in Cary, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.