Shane Bolina, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2025022146 Issued in MO

Practice address

551 Veterans United Dr
Columbia, MO 65201-8397

Phone

(573) 884-7733

Fax

(573) 884-7733

NPI assigned

Jun 20, 2025

Sex

Male

Sole proprietor

No

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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1003703224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652121000",
            "telephone_number": "573-884-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 VETERANS UNITED DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018397",
            "telephone_number": "573-884-7733",
            "fax_number": "573-884-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLINA",
        "first_name": "SHANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2025022146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clare Fielding Bogle, MSW, LCSW
• Megan Bogue, M.ED., LPC
• Richard Stanley Bohon, DDS
• Tiffany Melissa Bohon, M.D.
• Rebecca Boldt, DC
• Melody Ann Boling, LCSW
• Olivia Louise Bolles, MD
• Debra Jean Bolton, PT
• Meghan Boltz, RPH
• Marilee Green Bomar, MSN

• Family Medicine Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.