CMS-1500 Box 24J / 33a • NPI
1407672512
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LP2300X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care
Box 32 Service Location & ZIP+4
900 6TH ST SW STE 2, GREAT FALLS, MT, 59404-3207
✓ 9-Digit EDI 837 ZIP+4 (59404-3207)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1407672512 (KAYLA J BOLTZ, FNP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1407672512 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KAYLA J BOLTZ, FNP |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care NUCC Code: 363LP2300X (Nurse Practitioner, Primary Care) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 900 6TH ST SW STE 2, GREAT FALLS, MT, 59404-3207 |
| Practice Telephone / Fax | Tel: (406) 727-3242 | Fax: (406) 727-3161 |
| Administrative Mailing Address | PO BOX 684, FAIRFIELD, MT, 59436-0684 |
| Enumeration & Last Sync | Enumerated: 2024-11-25 | CMS Record Updated: 2024-11-25 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LP2300X)
What Does Taxonomy Code 363LP2300X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP2300X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KAYLA J BOLTZ, FNP)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LP2300X — Nurse Practitioner, Primary CarePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care | State: MT | License: 245583 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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