Boldage Pace Kentucky LLC

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

BOLDAGE PACE KENTUCKY LLC

Practice address

2050 E Parrish Ave
Owensboro, KY 42303-1448

Phone

(732) 806-3205

NPI assigned

May 17, 2023

Last updated

May 28, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

BOLDAGE PACE, LLCAs reported in NPPES

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

Authorized official

Name

Micheal Y Czermak

Title

Chief Administrative Officer

Phone

(855) 801-2653

Specialties & licenses 1

Addresses

Other names 1

• BoldAge PACE Other name

Locations

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1447941802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 EXMORE ROAD",
            "address_2": "SUITE 3",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 E PARRISH AVE",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031448",
            "telephone_number": "732-806-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLDAGE PACE KENTUCKY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOLDAGE PACE, LLC",
        "enumeration_date": "2023-05-17",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "CZERMAK",
        "authorized_official_first_name": "MICHEAL",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "855-801-2653"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BoldAge PACE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amber Elizabeth Boarman, SLP
• Andrea Boarman, CCC-SLP
• Chandra Nichole Boarman, COTA/L
• Jill Boeglin
• Marla D Boehman, LCSW
• Sarah Marie Boles, DPT
• Shafe D. Boles, M.D.
• Mary Elizabeth Bolin, DPT
• Michael Boling, CSW
• Mychal Bolton

• PACE Provider Organization in Owensboro, KY
• Providers in Owensboro, KY by specialty
• PACE Provider Organization in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.