Katherine Boles Maxey, R.D., L.D.N

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L003169 Issued in NC

Practice address

Wake Forest Baptist Health
Winston Salem, NC 27157-0001

Phone

(336) 713-8676

NPI assigned

Aug 2, 2016

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

Other names 1

• Ms. Katherine Anne Boles Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1902359458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WAKE FOREST UNIVERSITY HEALTH SCIENCES",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-713-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAKE FOREST BAPTIST HEALTH",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-713-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXEY",
        "first_name": "KATHERINE",
        "middle_name": "BOLES",
        "name_prefix": "Mrs.",
        "credential": "R.D., L.D.N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L003169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "BOLES",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "R.D., L.D.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacob Charles Maus, MD
• Sarah Elizabeth Maus, MD
• Ryan Cory Maves, M.D.
• Max Motion Physical Therapy, LLC
• Deborah Ariel Maxey
• Maxim Habilitation Services, LLC
• Maxim Healthcare Services, Inc.
• Kenneth Scruggs Maxwell, MD
• Marya Elise Maxwell, LCSW
• May Sun Home Health Nurses, PLLC

• Registered Dietitian in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.