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BLAKE EDWIN BOLEWARE
NPI 1013752955
Student in an Organized Health Care Education/Training Program in Hattiesburg, MS

Active since July 01, 2024
5001 HARDY ST, HATTIESBURG, MS 39402(601) 268-8000 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 6, 2026, Jul 1, 2024 (2 updates tracked since 2024).

About Blake Edwin Boleware NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLAKE EDWIN BOLEWARE (NPI 1013752955) is an individual student in an organized health care education/training program in Hattiesburg, Mississippi and active in the NPI registry since July 2024. He maintains a secondary practice location in Jackson.

NPPES Registry Identity

NPI1013752955
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBLAKE EDWIN BOLEWARE
Location Address5001 HARDY STHattiesburg, MS 39402-1308
Mailing Address5001 Hardy StHattiesburg, MS 39402-1308 · (601) 268-8000
Phone(601) 268-8000
Sole ProprietorNo
Enumeration DateJuly 1, 2024
Last NPPES UpdateApril 6, 20262 updates tracked since enumeration
NPPES CertifiedApril 6, 2026
✔ NPI 1013752955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
5001 HARDY ST, Hattiesburg, MS 39402
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Secondary Practice Location 1

Location 12500 N State StJackson, MS 39216-4500 · Phone (601) 984-5012

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH ALYSSA SMITH FNP-C
Nurse Practitioner (Primary Care)
5001 HARDY ST
HATTIESBURG, MS 39402
Lamar County (601) 268-8000
RIVER PHYSICIANS GROUP LLC
Emergency Medicine
5001 HARDY ST
HATTIESBURG, MS 39402
Lamar County (770) 874-5439
BRADLEY WILLIAMS DO
Emergency Medicine
5001 HARDY ST
HATTIESBURG, MS 39402
Lamar County (601) 296-3963
NATALIE-ROSE SMITH DO
Student in an Organized Health Care Education/Training Program
5001 HARDY ST
HATTIESBURG, MS 39402
Lamar County (407) 697-9118
MIJU YU KURTZWEIL D.O.
Emergency Medicine
5001 HARDY ST, MERIT HEALTH WESLEY
HATTIESBURG, MS 39402
Lamar County (601) 296-3963
DR. MAITREE K PATEL MD
Student in an Organized Health Care Education/Training Program
5001 HARDY ST
HATTIESBURG, MS 39402
Lamar County (601) 296-3963
ANNETTE LONGO MD
Emergency Medicine
5001 HARDY ST
HATTIESBURG, MS 39402
Lamar County (601) 268-8000
RUBY MCCULLOUGH HOPKINS MD
Student in an Organized Health Care Education/Training Program
5001 HARDY ST
HATTIESBURG, MS 39402
Lamar County (601) 268-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blake Boleware's NPI number?

The NPI number for Blake Boleware is 1013752955. It was assigned to this individual provider in the NPPES registry on July 1, 2024.

Where is Blake Boleware located?

Blake Boleware practices at 5001 Hardy St, Hattiesburg, MS 39402. The listed phone number is (601) 268-8000.

What is Blake Boleware's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Blake Boleware was last updated on April 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.