Kelly Bolam

Primary specialty

Chore ProviderTaxonomy code 372500000X

Practice address

6686 Campbell St
Taylor, MI 48180-1802

Phone

(313) 268-3348

NPI assigned

Aug 24, 2022

Last updated

Aug 24, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1780303560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14683 SHENANDOAH DR",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481937728",
            "telephone_number": "313-268-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6686 CAMPBELL ST",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481801802",
            "telephone_number": "313-268-3348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14683 Shenandoah Dr",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "MI",
            "postal_code": "481937728",
            "country_code": "US",
            "telephone_number": "313-268-3348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLAM",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of Michigan, Inc. (Fresenius Medical Care Taylor)
• BJ's Wholesale Club Inc.
• Bloom Wellness Counseling, LLC
• Maureen L Bogart, R.N.
• Ivy Boggia
• Michael Bolan, LMSW
• Manoo Boonsiri, M.D.
• James Alexander Borges, MD
• Bormans Inc (Farmer Jack Pharmacy)
• Bormans Inc (Farmer Jack Pharmacy)

• Chore Provider in Taylor, MI
• Providers in Taylor, MI by specialty
• Chore Provider in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.