NPIMap

Individual provider Active NPI

Preston Boles, DPM

  • Podiatrist
  • Greenwood, MS
National Provider Identifier
1699734855
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
80105 Issued in MS
Practice address
309 W Church St
Greenwood, MS 38930-4305
Phone
(662) 453-9004
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 80105 MS Primary

Addresses

Primary practice location

309 W Church St
Greenwood, MS 38930-4305

Mailing address

PO Box 1410
Clinic Administration
Greenwood, MS 38935-1410
Phone (662) 459-7189

Other identifiers 2

IdentifierTypeStateIssuer
00015222MedicaidMS
P00391905OtherMSMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070515000154 MS Practitioner - Podiatry 8224038906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
G a Carmichael Family Health Center, Inc.Group PAC ID 2567371032, 23 clinicians

Practice addresses (Care Compare)

200 Grand Blvd
Greenwood, MS 38930-3504
Phone (601) 859-5213

Merit-based Incentive Payment System (MIPS)

Final score
84.35 of 100Reported as individual
Quality
58.7
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105MSMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwood Leflore Hospital Podiatrist CurrentSince Apr 1, 2006 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
G a Carmichael Family Health Center Inc CurrentSince Jul 31, 2025 Accepting new patients
G a Carmichael Family Health Center, Inc CurrentSince Jul 31, 2025 Accepting new patients

Locations

1668 W Peace St
Canton, MS 39046
Phone (601) 859-0050

1401 River Rd
Greenwood, MS 38930
Phone (662) 459-2603

1401 River Rd
Fl 3
Greenwood, MS 38930

309 W Church St
Greenwood, MS 38930
Phone (662) 453-9004

309 W Church St
#B
Greenwood, MS 38930
Phone (662) 219-2903

Interoperability endpoints

  • Direct secure messaging: preston.boles@scs-direct.glh.org
  • Direct secure messaging: preston.boles.p1@direct.glh.nextgenshare.com

Organizations & group practices 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1699734855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1410",
            "address_2": "CLINIC ADMINISTRATION",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389351410",
            "telephone_number": "662-459-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W CHURCH ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304305",
            "telephone_number": "662-453-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLES",
        "first_name": "PRESTON",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MS",
            "license": "80105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00015222",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00391905",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

Verify at the official NPI Registry.