Kody Ryan Boles, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT306036 Issued in CA

Practice address

10625 Scripps Ranch Blvd Ste D2
San Diego, CA 92131-1012

Phone

(858) 324-5537

NPI assigned

Jul 10, 2024

Last updated

Jul 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Auto-Ness Physical TherapyGroup PAC ID 3870984487, 6 clinicians

Beth Scalone PT IncGroup PAC ID 6608848049, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Auto-Ness Physical Therapy

  • Physical Therapist
  • San Diego, CA
  • NPI 1134885700
  Medicare reassignment Care Compare group NPD
• Beth Scalone PT, Inc

  dba North County Water and Sports Therapy Center

  • Physical Therapy Clinic/Center
  • San Diego, CA
  • NPI 1396776704

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1922845619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10625 SCRIPPS RANCH BLVD STE D2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311012",
            "telephone_number": "206-491-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 SCRIPPS RANCH BLVD STE D2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311012",
            "telephone_number": "858-324-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLES",
        "first_name": "KODY",
        "middle_name": "RYAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT306036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Rose Bolen
• April Lyn Bolenbaugh, M.ED
• Alexander James Bolender
• Matthew Edward Bolerjack
• Callie Elizabeth Boles
• Scott M Boles, MD
• Leslie Boley
• Tami Bolf-Schmidt, NP
• Morgan Bolin
• Andrea Bolinger

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.