Tamika M Bolden Ravenell, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

POD.607 POD Issued in SC

Practice address

180 Wingo Way
Suite 201
Mount Pleasant, SC 29464-1810

Phone

(843) 856-5337

NPI assigned

Jun 4, 2008

Last updated

Dec 13, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Tamika M Bolden Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Charleston East Home health agency, Charleston, SC, CCN 427027

Merit-based Incentive Payment System (MIPS)

Final score

66.15 of 100Reported as individual

Quality

49.02

Promoting interoperability

65

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8926/brand/1/csg/1/fhir/r4
• Direct secure messaging: tamika.ravenell.1@8926.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coastal Podiatry LLC

  • Podiatrist
  • Mount Pleasant, SC
  • NPI 1588965586
  Medicare reassignment NPD Authorized official
• Coastal Podiatry, LLC

  • Podiatrist
  • Mount Pleasant, SC
  • NPI 1659648152
  Authorized official Same address or phone
• Coastal Podiatry, LLC

  • Foot & Ankle Surgery Podiatrist
  • Mount Pleasant, SC
  • NPI 1720356231
  NPD
• Rebecca Vision LLC

  • Optometrist
  • Orangeburg, SC
  • NPI 1598009847
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys SC, LLC

  dba Amedisys Home Health of Charleston East

  • Home Health Agency
  • Charleston, SC
  • NPI 1447218748
  Care Compare affiliation

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1598924581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294650783",
            "telephone_number": "916-215-1234",
            "fax_number": "843-606-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WINGO WAY",
            "address_2": "SUITE 201",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294641810",
            "telephone_number": "843-856-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN RAVENELL",
        "first_name": "TAMIKA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "POD.607 POD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP9889",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMIKA",
            "last_name": "BOLDEN",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leah Boepple, PHD
• Ilah Boggs
• Laura Bogue
• Lydia Maeve Boland
• Ruford Joseph Bolchoz Jr., D.M.D.
• John P Bolger, PH.D.
• Bon Secours St Francis Xavier Hospital, Inc. (Charleston Oncology A Department of Bon Secours St. Francis Hospital)
• Bon Secours St. Francis Xavier Hosptial, Inc. (Lowcountry Hematology and Oncology A Department of BSSFH)
• Lisa Marie Bonaventura, LMT
• Jason Carl Bonavito

• Podiatrist in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Podiatrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.