Active NPI
Heidi Kaye Boldt, PTA
- Physical Therapy Assistant
- Federal Way, WA
National Provider Identifier
1942594619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- P160050009
- Practice address
- 1010 S 336TH St Ste 210
Federal Way, WA 98003-7354 - Phone
- (253) 835-8091
- NPI assigned
- May 30, 2011
- Last updated
- May 30, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | P160050009 | WA | Primary |
Addresses
Primary practice location
1010 S 336TH St Ste 210
Federal Way, WA 98003-7354
Mailing address
36113 249TH Ave SE
Enumclaw, WA 98022-6845
Phone (360) 802-5530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P160050009 | WA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306713600000",
"number": "1942594619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36113 249TH AVE SE",
"city": "ENUMCLAW",
"state": "WA",
"postal_code": "980226845",
"telephone_number": "360-802-5530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 S 336TH ST STE 210",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980037354",
"telephone_number": "253-835-8091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDT",
"first_name": "HEIDI",
"middle_name": "KAYE",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-30",
"last_updated": "2011-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WA",
"license": "P160050009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.