Active NPI
Brandon Lee Bolton, RDN
- Registered Dietitian
- Phoenix, AZ
National Provider Identifier
1548811979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86079130
- Practice address
- 16251 N Cave Creek Rd
Phoenix, AZ 85032-2976 - Phone
- (480) 882-4545
- NPI assigned
- Sep 26, 2019
- Last updated
- Sep 26, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86079130 | NU | Primary |
Addresses
Primary practice location
16251 N Cave Creek Rd
Phoenix, AZ 85032-2976
Mailing address
8125 N Hayden Rd
Scottsdale, AZ 85258-2463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569456000000",
"number": "1548811979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8125 N HAYDEN RD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852582463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16251 N CAVE CREEK RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850322976",
"telephone_number": "480-882-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTON",
"first_name": "BRANDON",
"middle_name": "LEE",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-26",
"last_updated": "2019-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NU",
"license": "86079130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.