Active NPI
Keneisha Bolton
- Registered Nurse
- Kountze, TX
National Provider Identifier
1730689571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 897519
- Practice address
- 210 N. Cypress St.
Kountze, TX 77625-7762 - Phone
- (409) 679-6173
- NPI assigned
- Feb 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 Nurse | 163W00000X | 897519 | TX | Primary |
Addresses
Primary practice location
210 N. Cypress St.
Kountze, TX 77625-7762
Mailing address
PO Box 1208
Kountze, TX 77625-1208
Phone (409) 679-6173
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
| License | State | Type | Specialty |
|---|---|---|---|
| 897519 | TX | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518998400000",
"number": "1730689571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1208",
"city": "KOUNTZE",
"state": "TX",
"postal_code": "776251208",
"telephone_number": "409-679-6173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N. CYPRESS ST.",
"city": "KOUNTZE",
"state": "TX",
"postal_code": "776257762",
"telephone_number": "409-679-6173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTON",
"first_name": "KENEISHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-19",
"last_updated": "2018-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "897519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kountze, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.