Gregory C. Bolton Sr., M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD035094L Issued in PA

Practice address

100 E Lancaster Ave Ste 135
Wynnewood, PA 19096-3453

Phone

(610) 896-4380

Fax

(484) 572-0151

NPI assigned

Jun 28, 2006

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 PA

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

State licenses

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 and National Provider Directory roles.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Aria Health Physician Services

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053181297
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1043248271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 135",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963453",
            "telephone_number": "610-896-4380",
            "fax_number": "484-572-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 135",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963453",
            "telephone_number": "610-896-4380",
            "fax_number": "484-572-0151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Lancaster Ave",
            "address_2": "Suite 353 MOB East",
            "address_purpose": "LOCATION",
            "city": "Wynnewood",
            "state": "PA",
            "postal_code": "190963450",
            "country_code": "US",
            "telephone_number": "610-896-4380",
            "fax_number": "610-649-8058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "GREGORY",
        "middle_name": "C.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD035094L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Devins Block, RDN
• Shakia Mary Blount-Williams, CRNP
• Tyler Lawson Bogaczyk, MD
• Anne Marie Boguslavsky
• Stacylynne Bolks, FNP-BC
• Kathryn Marie Bormes
• Jeremy Chanan Boxer, M.D.
• Michael Anthony Braccia, DO
• Jason T. Bradley, M.D.
• Jennifer Brady, RD, LDN

• Obstetrics & Gynecology Physician in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Obstetrics & Gynecology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; 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.