Mychal Bolton

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

06195 Issued in KY

Practice address

1100 Walnut St
Owensboro, KY 42301-2956

Phone

(270) 689-6500

Fax

(270) 827-4671

NPI assigned

Apr 12, 2021

Last updated

Oct 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

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 2

Specialty

Psychiatry

Education

Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rivervalley Behavioral Health IncGroup PAC ID 4082522396, 22 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.17 of 100Reported as group

Quality

82.57

Promoting interoperability

100

Improvement activities

40

Cost

71.91

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rivervalley Behavioral Health Inc

  dba RiverValley Behavioral Health

  • Community Health Clinic/Center
  • Owensboro, KY
  • NPI 1285689711
  Medicare reassignment Care Compare group NPD
• Deaconess Hospital, Inc

  dba Deaconess Care Group

  • Hospitalist Physician
  • Evansville, IN
  • NPI 1427097443
  Medicare reassignment NPD
• Deaconess Hospital Inc

  • Mental Health Counselor
  • Evansville, IN
  • NPI 1508723552

  Psychiatry

  NPD
• Deaconess Hospital, Inc

  dba Deaconess Cross Pointe

  • Psychiatry Physician
  • Evansville, IN
  • NPI 1497862486
  NPD

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1043890304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1637",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423021637",
            "telephone_number": "270-689-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WALNUT ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423012956",
            "telephone_number": "270-689-6500",
            "fax_number": "270-827-4671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "618 N Green St",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "KY",
            "postal_code": "424202949",
            "country_code": "US",
            "telephone_number": "270-826-1978",
            "fax_number": "270-827-4671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "MYCHAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "02007052A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "06195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boldage Pace Kentucky LLC
• Sarah Marie Boles, DPT
• Shafe D. Boles, M.D.
• Mary Elizabeth Bolin, DPT
• Michael Boling, CSW
• Bon Harbor RX, LLC (Nation's Medicines)
• James Wes Booker, DMD
• Kerri Booker
• Valorie G Boone, CSW
• Alysia Booth, LCSW

• Psychiatry Physician in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.