Phalan Larese Bolden, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

255762 Issued in NC

Practice address

507 N Lindsay St
High Point, NC 27262-4303

Phone

(336) 883-0029

Fax

(336) 883-0867

NPI assigned

Dec 1, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• PLB Nursing Solutions PLLC

  • Nursing Care Agency
  • Charlotte, NC
  • NPI 1851870695
  NPD Authorized official
• Villagehealth DM LLC

  • Case Management Agency
  • Denver, CO
  • NPI 1598273211

  DC

  Medicare reassignment
• Bethany Medical Center

  • Pain Medicine (Anesthesiology) Physician
  • North Wilkesboro, NC
  • NPI 1508341736

  Family

  NPD (past)
• Bethany Medical Center

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1952404188

  Family

  NPD (past)
• Baystate Medical Practices, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Springfield, MA
  • NPI 1548205909
  NPD (past)

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1184952277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601067",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601067",
            "telephone_number": "704-373-0212",
            "fax_number": "704-373-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N LINDSAY ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624303",
            "telephone_number": "336-883-0029",
            "fax_number": "336-883-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "PHALAN",
        "middle_name": "LARESE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "255762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7006359",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2129",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184952277",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Blyth, M.D.
• Bmi Nephrology Systems, Inc.
• Elizabeth Gage Bockewitz, M.D.
• Gregory Bodenheimer, PHARMD
• Body & Soul Total Wellness, PLLC
• Joseph Boles
• Brittlee Lauren Bolton, BCBA
• Sarah Bone, PA-C
• Bertrand A Bonnick, DDS
• Tameka Borders, RN

• Family Nurse Practitioner in High Point, NC
• Providers in High Point, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.