William Bolden III

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP.11975 Issued in OH

Practice address

1325 Theatre Dr
Speech and Hearing A104 Center for the Performing Arts
Kent, OH 44242-0001

Phone

(330) 672-0248

NPI assigned

Sep 3, 2015

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Kent State University

  • Hearing and Speech Clinic/Center
  • Kent, OH
  • NPI 1689871220
  NPD

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1447628797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 THEATRE DR",
            "address_2": "SPEECH AND HEARING A104 CENTER FOR THE PERFORMING ARTS",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442420001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 THEATRE DR",
            "address_2": "SPEECH AND HEARING A104 CENTER FOR THE PERFORMING ARTS",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442420001",
            "telephone_number": "330-672-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "WILLIAM",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-03",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.11975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine A Blankenship, LISW-S
• Madison Elizabeth Blauvelt, ATC
• Bloom Occupational Therapy LLC
• Board of Education of the Kent City School District
• Gregory Boaz
• Teresa Y Bolt, LPCC-S
• Laura Bosko, PMHNP
• Beth Ann Bosley, LPN
• Victoria Larae Bosze, EP-C
• Kevin Michael Bovair

• Speech-Language Pathologist in Kent, OH
• Providers in Kent, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.