NPIMap

Individual provider Active NPI

John William Bolen Jr., MD

  • Diagnostic Radiology Physician
  • Galax, VA
National Provider Identifier
1265404925
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101040131 Issued in VA
Practice address
200 Hospital Dr
Galax, VA 24333-2227
Phone
(703) 236-8175
NPI assigned
Feb 6, 2006
Last updated
Feb 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101040131 VA Primary

Addresses

Primary practice location

200 Hospital Dr
Galax, VA 24333-2227

Mailing address

110 Valley St
Galax, VA 24333-2224

Other identifiers 2

IdentifierTypeStateIssuer
300038351OtherRAILROAD MEDICARE
007202865MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20091217000287 VA Practitioner - Diagnostic Radiology 4587619317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Virginia School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danville Physician Practices LLCGroup PAC ID 4688606304, 171 clinicians

Practice addresses (Care Compare)

53 Wild Turkey LN
Galax, VA 24333-4332
Phone (276) 233-4060

58 Wild Turkey LN
Galax, VA 24333-4695
Phone (276) 233-4060

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.55 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101040131VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Twin County Physician Practices LLC Diagnostic Radiology CurrentSince Jan 15, 2025 Accepting new patients
Danville Physician Practices LLC Diagnostic Radiology CurrentSince Jan 15, 2025 Accepting new patients
Danville Physician Practices LLC Current Accepting new patients
Raleigh Radiology Associates, Inc. Diagnostic Radiology CurrentSince Sep 28, 2022 Accepting new patients
DLP Twin County Physician Practices LLC CurrentSince Jan 15, 2025 Accepting new patients
Greensboro Pathology, LLC Current Accepting new patients
DLP Twin County Physician Practices LLC Current Accepting new patients
Twin County Family Care Centers Inc PastSince Sep 26, 2007 Accepting new patients
DLP Twin County Regional Healthcare LLC PastSince Apr 1, 2012 Accepting new patients
Raleigh Radiology Wakemed Imaging, LLC Diagnostic Radiology Past Accepting new patients

Locations

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

200 Hospital Dr
Galax, VA 24333
Phone (276) 236-6011

961 E Stuart Dr
Galax, VA 24333
Phone (276) 236-3931

600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1265404925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 VALLEY ST",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332227",
            "telephone_number": "703-236-8175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLEN",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101040131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300038351",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007202865",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galax, VA

Sources for this page

Verify at the official NPI Registry.