Bold City Orthotics and Prosthetics, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

BOLD CITY ORTHOTICS AND PROSTHETICS, LLC

Doing business as

Bold City Orthotics and Prosthetics

Practice address

7563 Philips Hwy Ste 204
Jacksonville, FL 32256-6838

Phone

(904) 686-8222

NPI assigned

Aug 22, 2024

Last updated

Jul 8, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrea Dean, CO

Title

Co-Owner, Orthotist

Phone

(904) 686-8222

Specialties & licenses 1

Addresses

Other names 1

• Bold City Orthotics and Prosthetics Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1992538276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7563 PHILIPS HWY STE 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566838",
            "telephone_number": "904-686-8222",
            "fax_number": "904-686-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7563 PHILIPS HWY STE 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566838",
            "telephone_number": "904-686-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLD CITY ORTHOTICS AND PROSTHETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-22",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CO-OWNER, ORTHOTIST",
        "authorized_official_telephone_number": "904-686-8222",
        "authorized_official_credential": "CO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bold City Orthotics and Prosthetics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bold City Orthotics and Prosthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bold City Behavioral Health
• Bold City Behavioral Services
• Bold City Chiropractic LLC
• Bold City Doula Coalition
• Bold City Integrative Care
• Bold City Therapy and Wellness LLC
• Bold Healthcare PLLC
• Tiffany Bolden
• Irina Eugenievna Boldt, M.D.
• Paul R Boldt, D.M.D.

• Prosthetic/Orthotic Supplier in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.