John A Bolin, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

010571 Issued in LA

Practice address

4630 Ambassador Caffery Pkwy
Ste 406
Lafayette, LA 70508-6949

Phone

(337) 989-8770

Fax

(337) 989-8768

NPI assigned

Dec 8, 2005

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• La Imaging Clinic, LLC

  • Speech-Language Pathologist
  • Alexandria, LA
  • NPI 1568628972
  Medicare reassignment NPD
• Womens Multi-Specialty Group LLC

  • Surgery Physician
  • Lafayette, LA
  • NPI 1265627509
  NPD (past)

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205811643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 AMBASSADOR CAFFERY PKWY",
            "address_2": "STE 406",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086949",
            "telephone_number": "337-989-8770",
            "fax_number": "337-989-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 AMBASSADOR CAFFERY PKWY",
            "address_2": "STE 406",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086949",
            "telephone_number": "337-989-8770",
            "fax_number": "337-989-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIN",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "010571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1442291",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1119491",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tramenia Shavon Bolden, MS
• Troy Anthony Bolden, RN
• Toni Lynn Bolfer
• Madison Rae Bolgiano, PA-C
• Victoria L Bolgiano, D.O.
• Chris Boling, LCSW
• Janice Rodgers Bolivar, RN,CARN
• David Jude Bollich, PA-C
• John Bollich, OD
• Thomas K Bond Sr., MD

• Surgery Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.