Kristyn Boza Bolton, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4425 Issued in SC

Practice address

67 President St
Charleston, SC 29425-4238

Phone

(843) 792-1414

NPI assigned

Jun 29, 2021

Last updated

May 18, 2024By 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.kristynboza@148560.advancedmd-direct.com

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.

• University Medical Associates of the Medical University of South Carol

  dba MUSC Physicians

  • Multi-Specialty Clinic/Center
  • Charleston, SC
  • NPI 1043241110
  Medicare reassignment
• Knoxville Center for Behavioral Medicine LLC

  • Psychiatric Hospital
  • Knoxville, TN
  • NPI 1710640776
  Medicare reassignment
• University Medical Associates of the Medical University of South Carol

  dba MUSC PHysicians

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1982678496

  Physician Assistant

  NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1316517774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 WELLSWOOD LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092436",
            "telephone_number": "865-455-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 PRESIDENT ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294254238",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "KRISTYN",
        "middle_name": "BOZA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "67 President St",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294254238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Cosgrove Bolick, NP
• Eric D Bolin, M.D.
• Rahul Reddy Bollam, MD
• Matthew Emil Boller, DMD
• Chandler Linwood Bolles, DO
• Lucy Bolton, LMT
• Kathy Bolus, MD
• Michael Bolus, MD, PHD
• Vincent Gregory Bolus, MD
• Ryley Bolyard

• Physician Assistant in Charleston, SC
• Providers in Charleston, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.