Active NPI
Cassie L Bolduc, CNS
- Clinical Nurse Specialist
- Columbus, IN
National Provider Identifier
1669941142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 71008787A
- Practice address
- 940 N Marr Rd Ste B
Columbus, IN 47201-2610 - Phone
- (812) 375-0272
- Fax
- (812) 375-1093
- NPI assigned
- Nov 14, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 28160216A | IN | |
| Clinical Nurse Specialist | 364S00000X | 71008787A | IN | Primary |
Addresses
Primary practice location
940 N Marr Rd Ste B
Columbus, IN 47201-2610
Mailing address
940 N Marr Rd Ste B
Columbus, IN 47201-2610
Phone (812) 375-0272
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cbolduc11699@edirect.crh.org | Direct |
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
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71008787A | IN | MD | Clinical Nurse Specialist |
Interoperability endpoints
- cbolduc11699@edirect.crh.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604275200000",
"number": "1669941142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 N MARR RD STE B",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472012610",
"telephone_number": "812-375-0272",
"fax_number": "812-375-1093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 N MARR RD STE B",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472012610",
"telephone_number": "812-375-0272",
"fax_number": "812-375-1093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDUC",
"first_name": "CASSIE",
"middle_name": "L",
"credential": "CNS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-14",
"last_updated": "2020-11-02",
"certification_date": "2020-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "IN",
"license": "28160216A",
"primary": false
},
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "IN",
"license": "71008787A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cbolduc11699@edirect.crh.org",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "940 N Marr Rd Ste B",
"city": "Columbus",
"state": "IN",
"country_code": "US",
"postal_code": "472012610",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Columbus, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.