Jill Maureen Bolling, ATC

Individual provider Active NPI Athletic Trainer · Overland Park, KS

NPI 1013170398 · NPPES record last updated Jul 7, 2008

Key facts

NPI
1013170398
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2006017384 (MO)
Practice address
6405 Metcalf Ave
Ste 220
Overland Park, KS 66202-3927
Phone
(816) 877-0561
Fax
(816) 877-0565
NPI assigned
Jul 7, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2006017384MOMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Arc Rehabilitation Services, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2006017384 MO Yes

Addresses

Primary practice location

6405 Metcalf Ave
Ste 220
Overland Park, KS 66202-3927

Mailing address

6405 Metcalf Ave
Ste 220
Overland Park, KS 66202-3927
Phone (816) 877-0561

Other providers in Overland Park, KS

All providers in Overland Park, KS · Athletic Trainer in Kansas

Sources for this page

Verify at the official NPI Registry.