Individual provider Active NPI

Elizabeth F. Bolick, CRNA

  • Certified Registered Nurse Anesthetist
  • Hickory, NC
National Provider Identifier
1114907888
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
165313 Issued in NC
Practice address
415 N Center St
Ste 201
Hickory, NC 28601-5036
Phone
(828) 327-8105
Fax
(828) 327-4245
NPI assigned
Jan 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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
Certified Registered Nurse Anesthetist 367500000X 165313 NC Primary

Addresses

Primary practice location

415 N Center St
Ste 201
Hickory, NC 28601-5036

Mailing address

415 N Center St
Ste 201
Hickory, NC 28601-5036
Phone (828) 327-8105

Other identifiers 1

IdentifierTypeStateIssuer
8052156MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050218000819 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365494267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

214 19TH St SE
Hickory, NC 28602-1369
Phone (240) 566-1629

2430 Emerald PL
Suite 103
Greenville, NC 27834-5743
Phone (252) 752-2140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
165313NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Center CurrentSince Mar 22, 2021 Accepting new patients
Catawba Valley Medical Center CurrentSince Mar 22, 2021 Accepting new patients
Catawba Valley Medical Center Current Accepting new patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Apr 1, 2017 Accepting new patients

Locations

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

218 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-7461

Organizations & group practices 4

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114907888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N CENTER ST",
            "address_2": "STE 201",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015036",
            "telephone_number": "828-327-8105",
            "fax_number": "828-327-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N CENTER ST",
            "address_2": "STE 201",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015036",
            "telephone_number": "828-327-8105",
            "fax_number": "828-327-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLICK",
        "first_name": "ELIZABETH",
        "middle_name": "F.",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "165313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8052156",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.