Active NPI
Stephen Louis Bollig, M.D.
- Family Medicine Physician
- Hendersonville, TN
National Provider Identifier
1295837151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 025717
- Practice address
- 625 E Main St
Suite 4
Hendersonville, TN 37075-2602 - Phone
- (615) 826-3121
- NPI assigned
- Sep 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 025717 | TN | Primary |
Addresses
Primary practice location
625 E Main St
Suite 4
Hendersonville, TN 37075-2602
Mailing address
625 E Main St
Suite 4
Hendersonville, TN 37075-2602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040211000831 | TN | Practitioner - Family Practice | 2769376664 | Practice locations: Hendersonville, TN |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025717 | TN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295837151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 E MAIN ST",
"address_2": "SUITE 4",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370752602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 E MAIN ST",
"address_2": "SUITE 4",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370752602",
"telephone_number": "615-826-3121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLLIG",
"first_name": "STEPHEN",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "025717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hendersonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.