Michelle Renee Bolling

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Practice address

4260 Fort Henry Dr Ste 18
Kingsport, TN 37663-2248

Phone

(423) 406-1200

NPI assigned

Aug 1, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

• Kingsport Adult Day Care

  • Adult Day Care Clinic/Center
  • Kingsport, TN
  • NPI 1174355093
  NPD Authorized official

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1003646449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 LAKE FOREST DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633773",
            "telephone_number": "423-782-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 FORT HENRY DR STE 18",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632248",
            "telephone_number": "423-406-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLING",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karolina Bocian
• Peter R Bockhorst, DO
• Michael Dahyl Boggan, M.D.
• Mircea Boiciuc, M.D.
• Malerie Bolinsky, DNP
• Todd Ryan Bomar, PMHNP-BC
• Ina Kay Bone
• Johnnie Bonner, PT
• James Michael Bookout, MD
• Benjamin Borders

• Adult Day Care Clinic/Center in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Adult Day Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.