Michael J Boland, MD

Key facts

NPI

1104867936

Entity type

Individual (NPI type 1)

Primary specialty

Cardiovascular Disease Physician 207RC0000X

License

06387 (MS)

Practice address

255 Baptist Blvd
Suite 402
Columbus, MS 39705

Phone

(662) 240-1412

Fax

(662) 240-1949

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 7

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.

• Monroe Health Services, Inc. Cardiovascular Disease Physician · Amory, MS · NPI 1225605942
  Medicare reassignment NPD CARDIOVASCULAR DISEASE · MS
• North Mississippi Gilmore Clinics, LLC Internal Medicine Physician · Amory, MS · NPI 1225502370
  Medicare reassignment NPD MS
• Columbus Cardiovascular Care PLLC Cardiovascular Disease Physician · Columbus, MS · NPI 1063425486
  NPD (past) Authorized official CARDIOVASCULAR DISEASE
• Monroe Health Services, Inc. Surgery Physician · Amory, MS · NPI 1386433860
  NPD
• North Mississippi Gilmore Clinics, LLC Anatomic Pathology & Clinical Pathology Physician · Amory, MS · NPI 1588128896
  NPD
• North Mississippi Gilmore Clinics, LLC Internal Medicine Physician · Hamilton, MS · NPI 1851855167
  NPD
• Baptist Memorial Hospital - Golden Triangle Inc. General Acute Care Hospital · Columbus, MS · NPI 1609830173
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael_boland_md_cardiology@yourcarecommunity.org

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 7, 2012.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1104867936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845827",
            "telephone_number": "901-227-4068",
            "fax_number": "901-227-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 BAPTIST BLVD",
            "address_2": "SUITE 402",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "39705",
            "telephone_number": "662-240-1412",
            "fax_number": "662-240-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "6387",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "056686",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "00027291",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "06387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "730-73298",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115039",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "730-01754",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "730-05844",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "730-05954",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009601740",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Columbus, MS · Cardiovascular Disease Physician in Mississippi