Individual provider Active NPI

Michael J Boland, MD

  • Cardiovascular Disease Physician
  • Columbus, MS
National Provider Identifier
1104867936
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
06387 Issued in MS
Practice address
255 Baptist Blvd
Suite 402
Columbus, MS 39705
Phone
(662) 240-1412
Fax
(662) 240-1949
NPI assigned
Jun 10, 2006
Last updated
Dec 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 6387 MS
Cardiovascular Disease Physician 207RC0000X 056686 GA
Cardiovascular Disease Physician 207RC0000X 00027291 AL
Cardiovascular Disease Physician 207RC0000X 06387 MS Primary

Addresses

Primary practice location

255 Baptist Blvd
Suite 402
Columbus, MS 39705

Mailing address

PO Box 405827
Atlanta, GA 30384-5827
Phone (901) 227-4068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20040921000576 MS Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4284602905 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00027291ALMDCardiovascular Disease Physician
056686GAMDCardiovascular Disease Physician
6387MSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Gilmore Clinics, LLC Current Accepting new patients
Monroe Health Services, Inc. Cardiovascular Disease CurrentSince Sep 15, 2021 Accepting new patients
Monroe Health Services, Inc. CurrentSince Sep 15, 2021 Accepting new patients
North Mississippi Gilmore Clinics, LLC CurrentSince Jan 1, 2019 Accepting new patients
North Mississippi Gilmore Clinics, LLC CurrentSince Jan 1, 2019 Accepting new patients
Columbus Cardiovascular Care PLLC Cardiovascular Disease PastSince Sep 4, 2006 Accepting new patients
Baptist Memorial Hospital - Golden Triangle Inc. Past Accepting new patients

Locations

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

1107 Earl Frye Blvd
Ste 3
Amory, MS 38821
Phone (662) 256-9590

1107 Earl Frye Blvd
Ste 5
Amory, MS 38821
Phone (662) 257-6705

1107 Earl Frye Blvd
Ste 6
Amory, MS 38821
Phone (601) 256-9327

1127 Earl Frye Blvd
Ste A
Amory, MS 38821
Phone (662) 257-2324

404 Gilmore Dr
Amory, MS 38821
Phone (662) 256-3564

Interoperability endpoints

  • Direct secure messaging: michael_boland_md_cardiology@yourcarecommunity.org

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

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

Verify at the official NPI Registry.