Active NPI
Debra Anderson Bolick, MD
- Psychiatry Physician
- Hickory, NC
National Provider Identifier
1164458956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 39548
- Practice address
- 255 18TH St SE
Hickory, NC 28602-1364 - Phone
- (828) 324-8191
- Fax
- (828) 324-8373
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 39548 | NC | Primary |
Addresses
Primary practice location
255 18TH St SE
Hickory, NC 28602-1364
Mailing address
255 18TH St SE
Hickory, NC 28602-1364
Phone (828) 324-8191
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8916461 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39548 | NC | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164458956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 18TH ST SE",
"city": "HICKORY",
"state": "NC",
"postal_code": "286021364",
"telephone_number": "828-324-8191",
"fax_number": "828-324-8373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 18TH ST SE",
"city": "HICKORY",
"state": "NC",
"postal_code": "286021364",
"telephone_number": "828-324-8191",
"fax_number": "828-324-8373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLICK",
"first_name": "DEBRA",
"middle_name": "ANDERSON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "39548",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8916461",
"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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.