McKayla Renee Boll, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Practice address

96 Olive St
Bolivar, NY 14715-1310

Phone

(716) 790-1069

NPI assigned

Jul 12, 2021

Last updated

Jun 21, 2024By 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)

Enrolled

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1528630399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 OLIVE ST",
            "city": "BOLIVAR",
            "state": "NY",
            "postal_code": "147151310",
            "telephone_number": "716-790-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 OLIVE ST",
            "city": "BOLIVAR",
            "state": "NY",
            "postal_code": "147151310",
            "telephone_number": "716-790-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLL",
        "first_name": "MCKAYLA",
        "middle_name": "RENEE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maidie Andrews, LPN
• Angela Renee Baron
• Jennifer Baxter, LPN
• Bolivar Fire Department, Inc.
• Bolivar-Richburg Central School District
• Tyler L Brown, M.A., CCC-SLP
• Sarah Elizabeth Burdick, LCSW
• Thomas G Caruso, BC-HIS
• Cassie Dora Craft, LPN
• Tracie Dawn Edwards, HEARING AID SPECIALI

• Pediatric Occupational Therapist in Bolivar, NY
• Providers in Bolivar, NY by specialty
• Pediatric Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.