ANTHONY B. BOLDEN (NPI# 1518020056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518020056 |
| Entity Type | Individual |
| Full Name | ANTHONY B. BOLDEN |
| Credential | PA-C |
| Practice Address |
14200 W Celebrate Life Way Goodyear AZ 85338-3007 |
| Practice Telephone | 6232073024 |
| Practice Fax Number | 6239328595 |
| Mailing Telephone | 6232073024 |
| Mailing Fax Number | 6239328595 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2016-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 3537 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3537 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 210296 | 05 |
| Street Address |
14200 W CELEBRATE LIFE WAY |
| City | GOODYEAR |
| State | AZ |
| Zip Code | 85338-3007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386648632 | Jennifer Lou Spicer | Physician Assistant | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2005-06-01 |
| 1831714989 | Jeremy Michael Gerber | Pharmacist | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2020-06-15 |
| 1477107613 | Matthew Ryan Spenla | Anesthesiology | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2019-07-25 |
| 1366920035 | Chelsey May Mccauley | Dietitian, Registered | 14200 W Celebrate Life Way, Goodyear, AZ 85338 | 2018-08-03 |
| 1649756396 | Sara Schumacher | Dietitian, Registered | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2018-07-16 |
| 1497231369 | Samantha Peterson | Dietitian, Registered | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2018-07-13 |
| 1962864397 | Jeffrey Paulus | Anesthesiology | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2016-03-24 |
| 1346617826 | Sarah Kristofik | Genetic Counselor, MS | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2015-08-31 |
| 1972911022 | Jordan Waypa | Nurse Practitioner | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2014-07-31 |
| 1780947028 | Vishangi Dave | Internal Medicine | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2012-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295226884 | Caroline Chang | Dentist | 15530 W Roosevelt St Ste E106, Goodyear, AZ 85338 | 2018-05-20 |
| 1609376714 | Rosanna Alvarez | Licensed Practical Nurse | 17432 W Elaine Dr, Goodyear, AZ 85338 | 2018-02-15 |
| 1023534419 | Jennifer Elizabeth Lawrence Dixon | Social Worker | 319 N Lichfield Rd, Suite 105, Goodyear, AZ 85338 | 2017-08-17 |
| 1346774916 | Vanessa Castillo | Specialist/Technologist | 18035 W. Yuma Rd, Goodyear, AZ 85338 | 2017-04-20 |
| 1386008076 | Hope Behavioral Health Residential Care | Substance Abuse Rehabilitation Facility | 15985 W.williams Street, Goodyear, AZ 85338 | 2016-04-08 |
| 1952760241 | Jeremy John Abdul-haqq | Dentist | 15661 W Roosevelt St Ste 102, Goodyear, AZ 85338 | 2016-02-16 |
| 1417206897 | Kelly Renee Filo | Occupational Therapy Assistant | 10189 S. Hacienda Dr., Goodyear, AZ 85338 | 2012-08-31 |
| 1194015545 | Nancy Ann Amore | Licensed Practical Nurse | 15578 W Yuma Road, Goodyear, AZ 85338 | 2011-04-19 |
| 1932409208 | Chung Counihan | Pharmacist | 9890 S Estrella Parkway, Goodyear, AZ 85338 | 2010-11-02 |
| 1053611327 | Traven Anderson | Pharmacist | 9890 South Estrella Parkway, Goodyear, AZ 85338 | 2010-11-02 |
| Find all providers in zip 85338 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386648632 | Jennifer Lou Spicer | Physician Assistant | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2005-06-01 |
| 1437780665 | Ryan Joseph Hill-falkenthal | Physician Assistant | 1325 N Litchfield Rd Ste 125, Goodyear, AZ 85395-1215 | 2020-01-27 |
| 1306497896 | Hannah Elizabeth Johnston | Physician Assistant | 1325 N Litchfield Rd Ste 125, Goodyear, AZ 85395-1215 | 2019-09-25 |
| 1760597389 | Jenise A Tondini | Physician Assistant | 14200 W Celebrate Life Way, Goodyear, AZ 85338-3007 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760030647 | Blaine Wesley Price | Physician Assistant | 796 W Jardin Dr, Casa Grande, AZ 85122-6162 | 2019-09-03 |
| 1790347292 | James M Goldhardt | Physician Assistant | 1400 S Dobson Rd Ste A200, Mesa, AZ 85202-4707 | 2019-07-03 |
| 1972166858 | Red Heart Surgical Assisting | Physician Assistant | 43643 W Arizona Ave, Maricopa, AZ 85138-5642 | 2019-04-17 |
| 1053898833 | Sportsmedicine Outreach Specialist | Physician Assistant | 13247 N 80th Pl, Scottsdale, AZ 85260-4903 | 2018-07-24 |
| 1912496712 | Hw Surgical Assist, Pllc | Physician Assistant | 4057 E Laurel Ave, Gilbert, AZ 85234 | 2018-05-07 |
| 1346741501 | Coraesthetics Pllc | Physician Assistant | 2008 E Laguna Dr, Tempe, AZ 85282 | 2018-02-23 |
| 1366955155 | Jennifer R Osborne | Physician Assistant | 100 S Eastern Dawn Ave, Tucson, AZ 85748-1708 | 2017-11-15 |
| 1669985198 | Jacki Nichols | Physician Assistant | 5055 N Rock Canyon Rd, Tucson, AZ 85750-6003 | 2017-11-06 |
| 1720597214 | Merieme Khamsi | Physician Assistant | 14674 W Mountain View Blvrd #210, Surprise, AZ 85374 | 2017-09-27 |
| 1801305073 | Panduga Surgical Care, Pllc | Physician Assistant | 4904 S Power Rd Ste 103, Pmb 450, Mesa, AZ 85212-3610 | 2017-09-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.