Charles Edward Bouldin, R.P.T.
NPI 1679690101ActiveIndividual· Specialist· Tupelo, MS
Specialist (R.P.T.) in Tupelo, Mississippi, licensed in MS, with an NPI issued in March 2007. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1679690101 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | R.P.T. |
| Sole proprietor | Yes |
| NPI issued | Mar 22, 2007 |
| Last updated in NPPES | Nov 8, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | PT0198 | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (MS) |
|---|
Education and affiliations
| Graduation year | 1976 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
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