Stephanie Bolin, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR3433 Issued in AR

Practice address

151 Southwest Dr
Jonesboro, AR 72401-5828

Phone

(870) 932-0090

Fax

(870) 930-9336

NPI assigned

Oct 20, 2020

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Female

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 AR

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gross Therapy Services IncGroup PAC ID 5991072050, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Gross Therapy Services, Inc.

  • Physical Therapist
  • Mountain Home, AR
  • NPI 1033236468

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Batesville Therapy Clinic, Inc

  dba Newport Physical Therapy and sports Medicine

  • Occupational Therapist
  • Batesville, AR
  • NPI 1194716258
  Medicare reassignment NPD
• Newport Advanced Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Newport, AR
  • NPI 1992827042
  NPD (past)

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1952900102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHWEST DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015828",
            "telephone_number": "870-932-0090",
            "fax_number": "870-930-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SOUTHWEST DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015828",
            "telephone_number": "870-932-0090",
            "fax_number": "870-930-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIN",
        "first_name": "STEPHANIE",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Alan Bolden
• Marsha A Bolden
• Kristina Bolick
• Betina Lynn Bolin, LCSW
• Jana Bolin
• Ashley Boling, PTA
• Baleigh Boling
• Jodi Shannon Boling, D.D.S.
• Robbie Scott Boling, MHPP
• Tipton Boling

• Occupational Therapist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.