Nicole Leigh Bolick, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

202500335 Issued in NC

Practice address

5815 Blakeney Park Dr Ste 100
Charlotte, NC 28277-5732

Phone

(704) 542-2220

Fax

(704) 542-3304

NPI assigned

May 1, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Dermatology

Education

Brody School of Medicine at East Carolina University, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Plastic Surgery and Dermatology PAGroup PAC ID 6800875188, 56 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Piedmont Plastic Surgery & Dermatology PA

  • Dermatology Physician
  • Gastonia, NC
  • NPI 1801832837
  Medicare reassignment Care Compare group NPD
• Piedmont Plastic Surgery and Dermatology

  • Dermatology Physician
  • Shelby, NC
  • NPI 1316056104
  NPD (past)

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1285255166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547488",
            "telephone_number": "980-399-6330",
            "fax_number": "704-671-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 BLAKENEY PARK DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282775732",
            "telephone_number": "704-542-2220",
            "fax_number": "704-542-3304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Msc07 4240 1 University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-6000",
            "fax_number": "505-272-6003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 S Sharon Amity Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282112886",
            "country_code": "US",
            "telephone_number": "704-344-8846",
            "fax_number": "704-344-9844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLICK",
        "first_name": "NICOLE",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "RS2022-0770",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "202500335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amir Dai Boler, LCMHCA
• Denita Boler, P-LCSW, QMHP
• Joanne Bolet Cafaro
• Michael S Bolewitz, PHARMD
• Sheree Boley, RN,CDE
• Devin Todd Bolin, RDH
• Shauna N Boling, PT
• Michael Bollin
• Elissa Ann Bolling, P.A.
• Katherine Isabella Bollinger, DPT

• Dermatology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.