Meagan Boll

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

390200000X Issued in ID

Practice address

500 W Fort St # 111R
Boise, ID 83702-4599

Phone

(208) 422-1314

Fax

(208) 422-1388

NPI assigned

Mar 20, 2023

Last updated

Mar 20, 2023By 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

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mboll2722420@direct.trinity-health.org

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1932801586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W FORT ST # 111R",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024599",
            "telephone_number": "208-422-1314",
            "fax_number": "208-422-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W FORT ST # 111R",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024599",
            "telephone_number": "208-422-1314",
            "fax_number": "208-422-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLL",
        "first_name": "MEAGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "390200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenna Bolen, LPC, CM, CBRS
• Kevin L Bolen, MS
• Sarah L Bolender, MD
• Neal Boliou, PHY.D.
• Patricia Boliou, LPC
• Gayla Tanaka Bollinger, PHARMD
• William A Bollinger, MD
• Makayla Bolls, DO
• Brett C Bollwinkel, PHARMD
• Crystal Bolter

• Internal Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.