AMY L BOLES (NPI# 1760473722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760473722 |
| Entity Type | Individual |
| Full Name | AMY L BOLES |
| Other Name | AMY L MEYER |
| Credential | MD |
| Practice Address |
1421 Premier Drive Mankato Clinic At Wickersham Campus Mankato MN 56001 |
| Mailing Address |
Po Box 8674 1230 E Main Street Mankato Clinic Ltd Mankato MN 56001 |
| Practice Telephone | 5076251811 |
| Mailing Telephone | 5076251811 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2020-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 48427 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | UCARE | 133219 | 01 |
| MN | MEDICA | 01-23833 | 01 |
| MN | BCBS | 523P5BO | 01 |
| MN | HEALTH PARTNERS | HP64495 | 01 |
| MN | PREFERRED ONE | NA2951047341 | 01 |
| MN | 057753700 | 05 | |
| IOWA MA | 0724203 | 01 | |
| MN | AMERICA'S PPO | 2443242 | 01 |
| MN | SANFORD HEALTH PLAN | 54093 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801212618 | Amy Boles | Speech-Language Pathologist | 912 S Gay St Ste 805, Knoxville, TN 37902-1814 | 2014-03-17 |
| Street Address |
1421 PREMIER DRIVE MANKATO CLINIC AT WICKERSHAM CAMPUS |
| City | MANKATO |
| State | MN |
| Zip Code | 56001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528399417 | Heidi Ginny Gehrke | Physician Assistant | 1421 Premier Drive, Mankato, MN 56001-5066 | 2010-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497281968 | Daniel Joseph Olson | Family Medicine | 101 Martin Luther King Jr. Dr, Mankato, MN 56001 | 2017-05-03 |
| 1144417684 | Scott David Rassbach | Family Medicine | Mayo Clinic Health System Southwest Mn Region, 101 Martin Luther King Jr Drive, Mankato, MN 56001 | 2007-09-28 |
| 1154319556 | Randall Charles Hurd | Family Medicine | 21 Carkoski Commons, Minnesota State University, Mankato, Mankato, MN 56001-6030 | 2005-10-10 |
| 1326046731 | Scott Rodney Helmers | Family Medicine | 101 Martin Luther King Dr, Mankato, MN 56001-6460 | 2005-07-09 |
| 1457916470 | Lance Deeter | Family Medicine | 101 Martin Luther King Dr, Mankato, MN 56001-6460 | 2019-05-06 |
| 1962065656 | Trenton E Harder | Family Medicine | 101 Martin Luther King Dr, Mankato, MN 56001-6460 | 2019-04-17 |
| 1801381603 | Nicole Fischbach | Family Medicine | 1421 Premier Dr, Mankato, MN 56001-6076 | 2018-06-25 |
| 1265920789 | Grant Scott Bludorn | Family Medicine | 101 Martin Luther King Dr, Mankato, MN 56001-6460 | 2018-04-30 |
| 1669969085 | Jacan Simon | Family Medicine | 101 Martin Luther King Dr, Mankato, MN 56001-6460 | 2018-04-20 |
| 1689171894 | Cory Simning | Family Medicine | 101 Martin Luther King Dr, Mankato, MN 56001-6460 | 2018-04-12 |
| Find all providers in MANKATO | ||||
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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.