KYLE BOLTON
NPI 1861151326
Dietitian, Registered in Fort Drum, NY

Active since December 13, 2021
20460 ANACONDA RD, FORT DRUM, NY 13603(480) 387-0619 Get Directions Write a Review

NPPES record last updated: March 18, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 18, 2025, Dec 13, 2021 (2 updates tracked since 2021).

About Kyle Bolton NPPES

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

KYLE BOLTON (NPI 1861151326) is an individual dietitian, registered in Fort Drum, New York and active in the NPI registry since December 2021.

NPPES Registry Identity

NPI1861151326
Entity TypeIndividualMale
Primary Taxonomy133V00000X
Provider Legal NameKYLE BOLTON
Location Address20460 ANACONDA RDFort Drum, NY 13603
Mailing Address20460 Anaconda RdFort Drum, NY 13603 · (480) 387-0619
Sole ProprietorNo
Enumeration DateDecember 13, 2021
Last NPPES UpdateMarch 18, 20252 updates tracked since enumeration
NPPES CertifiedMarch 13, 2025
NPI 1861151326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

20460 ANACONDA RD, Fort Drum, NY 13603

Other Providers at the Same Location NPPES 2

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

Specialist/Technologist (Athletic Trainer)
20460 ANACONDA RD
FORT DRUM, NY 13603
Specialist/Technologist (Athletic Trainer)
20460 ANACONDA RD
FORT DRUM, NY 13603

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 Kyle Bolton's NPI number?

The NPI number for Kyle Bolton is 1861151326. It was assigned to this individual provider in the NPPES registry on December 13, 2021.

Where is Kyle Bolton located?

Kyle Bolton practices at 20460 Anaconda Rd, Fort Drum, NY 13603. The listed phone number is (480) 387-0619.

What is Kyle Bolton's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

When was this NPI record last updated?

The NPPES record for Kyle Bolton was last updated on March 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.