Individual provider Active NPI

Taylor Jean Boll

  • Physical Therapy Assistant
  • Bismarck, ND
National Provider Identifier
1649064973
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1367A Issued in ND
Practice address
301 Lorrain Dr
Bismarck, ND 58503-0311
Phone
(701) 899-1114
NPI assigned
Apr 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1367A ND Primary

Addresses

Primary practice location

301 Lorrain Dr
Bismarck, ND 58503-0311

Mailing address

202 E Greenfield LN Unit D205
Bismarck, ND 58503-6594
Phone (701) 899-1114

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1367ANDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1649064973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E GREENFIELD LN UNIT D205",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585036594",
            "telephone_number": "701-899-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LORRAIN DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030311",
            "telephone_number": "701-899-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLL",
        "first_name": "TAYLOR",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ND",
            "license": "1367A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.