Active NPI
Olivia Louise Bolles, MD
- Surgery Physician
- Columbia, MO
National Provider Identifier
1013178946
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Oct 20, 2015.
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 2008017225
- Practice address
- 1 Hospital Dr
Columbia, MO 65212-0001 - Phone
- (573) 882-4141
- NPI assigned
- Jun 23, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2008017225 | MO | Primary |
Addresses
Primary practice location
1 Hospital Dr
Columbia, MO 65212-0001
Mailing address
1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008017225 | MO | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214179200000",
"number": "1013178946",
"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": "652120001",
"telephone_number": "573-882-4141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HOSPITAL DR",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652120001",
"telephone_number": "573-882-4141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLLES",
"first_name": "OLIVIA",
"middle_name": "LOUISE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-23",
"last_updated": "2008-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "2008017225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.