NPIMap

Individual provider Active NPI

William Scott Bohlke, MD

  • Family Medicine Physician
  • Brooklet, GA
National Provider Identifier
1225141997
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
037490 Issued in GA
Practice address
128 North Parker Avenue
Brooklet, GA 30415-0487
Phone
(912) 842-2101
Fax
(912) 842-2103
NPI assigned
Aug 16, 2006
Sex
Male
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
Family Medicine Physician 207Q00000X 037490 GA Primary

Addresses

Primary practice location

128 North Parker Avenue
Brooklet, GA 30415-0487

Mailing address

128 North Parker Avenue
PO Box 487
Brooklet, GA 30415-0487
Phone (912) 842-2101

Other identifiers 1

IdentifierTypeStateIssuer
00593557DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050908000074 GA Practitioner - Family Practice 7719919026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

128 Parker Ave N
Brooklet, GA 30415-8208
Phone (912) 842-2101

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Statesboro, GA, CCN 117033
  • Enhabit Home Health Home health agency, Hartwell, GA, CCN 117069
  • Ogeechee Area Hospice, Inc. Hospice, Statesboro, GA, CCN 111535
  • East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
  • Candler Hospital Hospital, Savannah, GA, CCN 110024
  • Effingham Health System Hospital, Springfield, GA, CCN 111306
  • Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036
  • St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth13
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Nov 3, 2017 Accepting new patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Nov 3, 2017 Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: william.scott.bohlke.1@8042.direct.athenahealth.com

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 8

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225141997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 NORTH PARKER AVENUE",
            "address_2": "PO BOX 487",
            "city": "BROOKLET",
            "state": "GA",
            "postal_code": "304150487",
            "telephone_number": "912-842-2101",
            "fax_number": "912-842-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 NORTH PARKER AVENUE",
            "city": "BROOKLET",
            "state": "GA",
            "postal_code": "304150487",
            "telephone_number": "912-842-2101",
            "fax_number": "912-842-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHLKE",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "037490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00593557D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklet, GA

Sources for this page

Verify at the official NPI Registry.