MARK EDWARD BOULDEN JR. ATC
NPI 1053764977
Specialist/Technologist - Athletic Trainer in Georgetown, SC

Q: What is Mark Boulden's NPI number?

The NPI number for Mark Boulden is 1053764977. It was assigned to this individual provider in the NPPES registry on July 15, 2016.

Q: What is Mark Boulden's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

Q: When was this NPI record last updated?

The NPPES record for Mark Boulden was last updated on July 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.

Active since July 15, 2016

2185 N FRASER ST, GEORGETOWN, SC 29440(843) 527-1800(843) 527-6528 Get Directions Write a Review

NPPES record last updated: July 15, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mark Edward Boulden Jr. Atc NPPES

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

MARK EDWARD BOULDEN JR. ATC (NPI 1053764977) is an individual athletic trainer provider in Georgetown, South Carolina, licensed in South Carolina (1667) and active in the NPI registry since July 2016.

NPPES Registry Identity

NPI1053764977

Entity TypeIndividualMale

Primary Taxonomy2255A2300X

Provider Legal NameMARK EDWARD BOULDEN JR.Credential: ATC

Location Address2185 N FRASER STGeorgetown, SC 29440-6418

Mailing Address2185 N Fraser StGeorgetown, SC 29440-6418 · (843) 527-1800 · Fax (843) 527-6528

Phone(843) 527-1800

Fax(843) 527-6528

Sole ProprietorNo

Enumeration DateJuly 15, 2016

✔ NPI 1053764977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2255A2300X

License✔ Licensed in SC · 1667

Definition

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

2185 N FRASER ST, Georgetown, SC 29440

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Other Providers at the Same Location NPPES 7

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

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