Mitchell Boles, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN233677 Issued in GA

Practice address

1665 Highway 34 E Ste 100
Newnan, GA 30265-2404

Phone

(770) 252-7557

Fax

(770) 252-7513

NPI assigned

May 1, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City of Hope Medical Group of Georgia LLCGroup PAC ID 4880841212, 137 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeastern Regional Medical Center, Inc Hospital, Newnan, GA, CCN 110233

Merit-based Incentive Payment System (MIPS)

Final score

79.74 of 100Reported as group

Quality

63.81

Promoting interoperability

100

Improvement activities

40

Cost

57.71

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mboles145038@cityofhope.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• City of Hope Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Newnan, GA
  • NPI 1447520333

  GA, Single Specialty

  Medicare reassignment Care Compare group NPD
• Cogent Healthcare of Georgia PC

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1609827823

  GA, Single Specialty

  Medicare reassignment NPD
• Sound Physicians Intensivists of Georgia PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Macon, GA
  • NPI 1376159590

  GA, Single Specialty

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southeastern Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Newnan, GA
  • NPI 1235417288

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1003470402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 HIGHWAY 34 E STE 100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652404",
            "telephone_number": "770-252-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 HIGHWAY 34 E STE 100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652404",
            "telephone_number": "770-252-7557",
            "fax_number": "770-252-7513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105A Corporate Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302412801",
            "country_code": "US",
            "telephone_number": "678-800-0099",
            "fax_number": "770-252-7513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLES",
        "first_name": "MITCHELL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-01",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN233677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mboles@gapaincare.com",
            "affiliation": "N",
            "endpointDescription": "Company Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1665 Highway 34 E Ste 100",
            "city": "Newnan",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302652404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blueprint Psychiatry, LLC
• Blueprint TMS& Wellness Centers of America
• Jennifer Alice Boateng
• Bobbi Personal Care Home Inc.
• Sushanth Raghu Boda, DO
• Shannon Leigh Boles, PNP
• Hannah Booth
• Emma Borglin, RBT
• Anntioneek Marshelle Boston
• William T Bottoms Jr., MD

• All providers in Newnan, GA
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.