Jacy Renee Boldebuck, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

127463121 Issued in WI

Practice address

2500 Overlook Ter
B3075
Madison, WI 53705-2254

Phone

(608) 280-7084

NPI assigned

Nov 6, 2008

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

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": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1497909238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 ASH ST",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535753429",
            "telephone_number": "608-835-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 OVERLOOK TER",
            "address_2": "B3075",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052254",
            "telephone_number": "608-280-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEBUCK",
        "first_name": "JACY",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "127463121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Mary Boissonnault, CRNA
• William G Boissonnault
• Lamin Bojang
• Matida Bojang, MD
• Thomas Brendan Boland, MD
• Jilaine M. Bolek Berquist, M.D.
• Anna L Bolha, PA-C
• Valerie A Boll, NP
• Karen Bollefer, LPN
• Nicole Bollenbacher

• Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; 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.