Paul A Boland, CPO

Primary specialty

SpecialistTaxonomy code 174400000X

License

000006 Issued in GA

Practice address

110 Osigian Blvd
Warner Robins, GA 31088-7880

Phone

(478) 953-2922

Fax

(478) 953-2927

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417024670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 LUCKY DEBONAIR DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101212",
            "telephone_number": "478-953-2922",
            "fax_number": "478-953-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 OSIGIAN BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310887880",
            "telephone_number": "478-953-2922",
            "fax_number": "478-953-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CPO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "000006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE O&P LICENSE",
            "identifier": "000006",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABC CERT PROSTH & ORTHO",
            "identifier": "CPO 1780",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Debra Borden
• Hui Bostian
• Jessica Leigh Bostic

• Specialist in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.