Individual provider Active NPI

Bo Poulson, MD

  • Emergency Medicine Physician
  • Emporia, VA
National Provider Identifier
1184660615
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101239075 Issued in VA
Practice address
727 N Main St
Emporia, VA 23847-1274
Phone
(434) 348-4500
Fax
(434) 348-4506
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101239075 VA Primary

Addresses

Primary practice location

727 N Main St
Emporia, VA 23847-1274

Mailing address

8717 Greenford Dr
Richmond, VA 23294-6130
Phone (804) 270-3072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20070207000621 UT Practitioner - Emergency Medicine 2961408216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 E S Temple
Salt Lake City, UT 84102-1507
Phone (801) 350-4111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101239075VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince Sep 25, 2024 Accepting new patients
Monacan Emgergency Physicians Emergency Medicine Past Accepting new patients

Locations

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

2690 N 600 W
Pleasant View, UT 84414
Phone (801) 786-7911

3451 W 5600 S
Roy, UT 84067
Phone (801) 896-5600

333 N 300 W
Salt Lake City, UT 84103
Phone (801) 463-7415

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

2055 N Main St
Tooele, UT 84074
Phone (435) 843-3600

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184660615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8717 GREENFORD DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232946130",
            "telephone_number": "804-270-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N MAIN ST",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "238471274",
            "telephone_number": "434-348-4500",
            "fax_number": "434-348-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSON",
        "first_name": "BO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101239075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emporia, VA

Sources for this page

Verify at the official NPI Registry.