Carissa Martine Bolden, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

902960 Issued in MS

Practice address

249 Beauvoir Rd Ste B2
Biloxi, MS 39531-4008

Phone

(601) 283-8999

NPI assigned

Nov 30, 2018

Last updated

Jan 8, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Coastal Family Health Center, Inc

  dba Coastal Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Biloxi, MS
  • NPI 1629066782
  Medicare reassignment NPD
• Nucare Medical and Weight Loss Center

  • Family Nurse Practitioner
  • Biloxi, MS
  • NPI 1437882800
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  MS

  Medicare reassignment NPD
• Coastal Family Health Center, Inc

  dba CFHC Mental Health Mobile Unit

  • Federally Qualified Health Center (FQHC)
  • Biloxi, MS
  • NPI 1104010834
  NPD
• Coastal Family Health Center, Inc

  dba Coastal Family Health Center, Inc Central Elementary

  • Federally Qualified Health Center (FQHC)
  • Lucedale, MS
  • NPI 1427842913
  NPD

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673136000000",
    "number": "1366912529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 SELLERS ST",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "395778743",
            "telephone_number": "601-528-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 BEAUVOIR RD STE B2",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395314008",
            "telephone_number": "601-283-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "CARISSA",
        "middle_name": "MARTINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2023-01-08",
        "certification_date": "2023-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Ann Boddyr
• Danielle Bodin, PMHNP
• Katharine Bogard, FNP-C
• Brennan Dean Bohman, DO
• Brian Robert Boiko, D.P.T.
• Hasani K Bolden
• Kayla Bolt
• Bond and Bloom Counseling, PLLC
• Robert J Bonhomme, MD
• Skylar Jo Freeman Boose

• Family Nurse Practitioner in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2023; 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.