Michael Patrick Boltin

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2874 Issued in SC

Practice address

212 Robin Rd
Lexington, SC 29073-9413

Phone

(843) 253-6781

NPI assigned

Nov 26, 2014

Last updated

Nov 26, 2014By the provider in NPPES

Sex

Male

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": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416960000000",
    "number": "1790182236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 ROBIN RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290739413",
            "telephone_number": "843-253-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 ROBIN RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290739413",
            "telephone_number": "843-253-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTIN",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-26",
        "last_updated": "2014-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "2874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis Blubaugh
• Blue Heron Wellness LLC
• Karen Small Boatwright
• Gordon H Bobbett II, MD
• Megan S Boltin, M.D.
• Hannah Bolton
• Debra E. Bonaparte, MSW, LMSW
• Stephanie Bonnett, LPC-A
• Julia Bonnette, MA-SLP
• Misti Dawn Booher, PA

• Physical Therapy Assistant in Lexington, SC
• Providers in Lexington, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; 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.