MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT) – Physical Therapist, NPI 1174002364

MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT) is a healthcare provider. based in Independence, Missouri. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT, ATC, LAT. They hold a License No. 2015028356 (MO). The NPI Number for MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT) is 1174002364

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT)
NPI
1174002364
Phone
(816) 373-9328
Address
2301 SOUTH 291 HIGHWAY
Enumeration Date
9 August 2018
Last Update Date
24 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8774073422
Graduation Year
2018 (8 years ago)
PAC ID
7517329378
Group Practice PAC ID
1254754948
Professional Enrollment ID
I20230811000268
Address ID
MO630904365WA1650XSTXX300
Telehealth
Yes

Contacts

Main Contact
https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:7State licenses:2Other namesUpdated within 12 months

1,533 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MO

Provider Addresses for MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT)

  • 2301 SOUTH 291 HIGHWAY

    INDEPENDENCE, MO 64057

    Phone: (816) 373-9328

    Fax: (816) 373-9207

    Type: Location

  • 316, Dains Street, Liberty, Clay County, Missouri, 64068, United States

    LIBERTY, MO 640682072

    Phone: (816) 654-3748

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230811000268IPhysical Therapist In Private PracticeMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities23415$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes18715$0
97116Therapy procedure for walking training, each 15 minutes11614$0
View full utilization report →

Insurance plans in this area (ZIP 64057)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254754948View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNJ
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeMO

Reviews

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Frequently asked questions

Can I cross-check MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT) using NPI 1174002364?
NPI 1174002364 belongs to MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT); compare other details if you need extra assurance.
Would MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT) appear as active to a payer?
You can treat MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT)?
MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT)'s record emphasizes Physical Therapist. Clinical services aligned with this taxonomy classification.
Is MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT) located near Independence?
MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT) currently maps to Independence, Missouri in this extract.
Does MISS JUSTINE BARYE BOLTON (PT, DPT, ATC, LAT) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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