NPIMap

Individual provider Active NPI

James Harley Bollinger, DDS

  • General Practice Dentistry
  • Cape Girardeau, MO
National Provider Identifier
1073679197
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
013718 Issued in MO
Practice address
3250 Gordonville Rd Ste 201
Cape Girardeau, MO 63703-5095
Phone
(573) 334-6660
Fax
(573) 334-6769
NPI assigned
Jan 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 013718 MO Primary

Addresses

Primary practice location

3250 Gordonville Rd Ste 201
Cape Girardeau, MO 63703-5095

Mailing address

3250 Gordonville Rd Ste 201
Cape Girardeau, MO 63703-5095
Phone (573) 334-6660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151222002439 MO Order and Referring Only - DentistPractitioner - Dentist 7719288497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Ownership & related parties

All facility ownership & control disclosures 13

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Saint Francis Medical CenterCape Girardeau, MO, CCN 260183 Hospital Corporate Director Jun 28, 2021
St Francis Medical CenterCape Girardeau, MO, CCN 26T183 Hospital Corporate Director Dec 1, 2015
Saint Francis HospiceCape Girardeau, MO, CCN 261657 Hospice Corporate Director Jun 28, 2021
Saint Francis Clinic DexterDexter, MO, CCN 793839 Rural health clinic Corporate Director Jul 1, 2019
Saint Francis Clinic Cape Girardeau KingshighwayCape Girardeau, MO, CCN 263897 Rural health clinic Corporate Director (100%) Jul 1, 2019
Saint Francis Clinic Poplar BluffPoplar Bluff, MO, CCN 263968 Rural health clinic Corporate Director Jul 1, 2019
Saint Francis Clinic PiedmontPiedmont, MO, CCN 263933 Rural health clinic Corporate Director Jul 1, 2019
Saint Francis Clinic JacksonJackson, MO, CCN 263914 Rural health clinic Corporate Director (100%) Jul 1, 2019
Saint Francis Clinic CharlestonCharleston, MO, CCN 263830 Rural health clinic Corporate Director (100%) Jul 1, 2019
Saint Francis Clinic Scott CityScott City, MO, CCN 268933 Rural health clinic Corporate Director (100%) Jul 1, 2019
Saint Francis Clinic East PrairieEast Prairie, MO, CCN 263930 Rural health clinic Corporate Director (100%) Jul 1, 2019
Saint Francis Clinic SikestonSikeston, MO, CCN 263931 Rural health clinic Corporate Director (100%) Jul 1, 2019
Saint Francis Clinic FarmingtonFarmington, MO, CCN 793859 Rural health clinic Corporate Director Jul 16, 2021

Owned or controlled facilities with NPI records 14

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073679197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 GORDONVILLE RD STE 201",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035095",
            "telephone_number": "573-334-6660",
            "fax_number": "573-334-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 GORDONVILLE RD STE 201",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035095",
            "telephone_number": "573-334-6660",
            "fax_number": "573-334-6769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLINGER",
        "first_name": "JAMES",
        "middle_name": "HARLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "013718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.