NPIMap

Individual provider Active NPI

Emily Rebecca Bolling, PA-C

  • Physician Assistant
  • South Charleston, WV
National Provider Identifier
1316962863
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1147 Issued in WV
Practice address
4610 Kanawha Ave SW Ste 200
South Charleston, WV 25309-1367
Phone
(304) 205-7992
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1147 WV Primary

Addresses

Primary practice location

4610 Kanawha Ave SW Ste 200
South Charleston, WV 25309-1367

Mailing address

4610 Kanawha Ave SW Ste 200
South Charleston, WV 25309-1367
Phone (304) 205-7992

Other practice location 1

800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone (304) 388-5432

Other practice location 2

3200 MacCorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

Other practice location 3

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Other practice location 4

1400 Hospital Dr
Hurricane, WV 25526-9202
Phone (304) 757-1700

Other identifiers 1

IdentifierTypeStateIssuer
1147OtherWVWV LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emily.bolling@vandaliahealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20051017000920 WV Practitioner - Physician Assistant 8729004098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4610 Kanawha Ave SW
Suite 200
South Charleston, WV 25309-1367
Phone (304) 205-7992

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1147WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Sep 14, 2025 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Sep 14, 2025 Accepting new patients

Locations

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1400 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-1700

4610 Kanawha Ave SW
Ste 200
South Charleston, WV 25309
Phone (304) 205-7992

Organizations & group practices 3

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 12

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1316962863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 KANAWHA AVE SW STE 200",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091367",
            "telephone_number": "304-205-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 KANAWHA AVE SW STE 200",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091367",
            "telephone_number": "304-205-7992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253023351",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "fax_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041227",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Hurricane",
            "state": "WV",
            "postal_code": "255269202",
            "country_code": "US",
            "telephone_number": "304-757-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLING",
        "first_name": "EMILY",
        "middle_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "1147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV LICENSE",
            "identifier": "1147",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emily.bolling@vandaliahealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4610 Kanawha Ave SW Ste 200",
            "city": "South Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253091367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.