Bold City Integrative Care

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BOLD CITY INTEGRATIVE CARE

Practice address

8110 Blanding Blvd Ste 6
Jacksonville, FL 32244-5823

Phone

(904) 274-0532

NPI assigned

Mar 14, 2022

Organization subpart

No

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

Authorized official

Name

Katelyn Bryant, NPNPI 1417297854

Title

Aprn

Phone

(904) 400-0120

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katelyn Lee Bryant, APRN

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1417297854
  NPD Authorized official

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1750039244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 OTIS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322202942",
            "telephone_number": "904-400-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 BLANDING BLVD STE 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445823",
            "telephone_number": "904-274-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLD CITY INTEGRATIVE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "KATELYN",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "904-400-0120",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bold Child Co.
• Bold City Behavioral Health
• Bold City Behavioral Services
• Bold City Chiropractic LLC
• Bold City Doula Coalition
• Bold City Orthotics and Prosthetics, LLC (Bold City Orthotics and Prosthetics)
• Bold City Therapy and Wellness LLC
• Bold Healthcare PLLC
• Tiffany Bolden
• Irina Eugenievna Boldt, M.D.

• Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.