Heather Bolen, MSPT, CERT MDT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-03888 Issued in KS

Practice address

601 Cross St
Burlington, KS 66839-1105

Phone

(620) 364-2117

NPI assigned

Apr 26, 2016

Last updated

Apr 26, 2016By 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

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1528413697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 22ND RD NW",
            "city": "LEBO",
            "state": "KS",
            "postal_code": "668569324",
            "telephone_number": "620-203-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CROSS ST",
            "city": "BURLINGTON",
            "state": "KS",
            "postal_code": "668391105",
            "telephone_number": "620-364-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLEN",
        "first_name": "HEATHER",
        "name_prefix": "Mrs.",
        "credential": "MSPT, CERT MDT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Burlington, KS
• Providers in Burlington, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.