Individual provider Active NPI

Dane Bolton, DO

  • Orthopaedic Surgery Physician
  • Montgomery, OH
National Provider Identifier
1326434317
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OT016537 Issued in PA
Practice address
10663 Montgomery Rd
Montgomery, OH 45242-4403
Phone
(513) 347-9999
NPI assigned
Apr 7, 2015
Last updated
Jun 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OT016537 PA Primary

Addresses

Primary practice location

10663 Montgomery Rd
Montgomery, OH 45242-4403

Mailing address

10663 Montgomery Rd
Montgomery, OH 45242-4403
Phone (513) 347-9999

Other practice location 1

1710 Hourglass Pt
Hixson, TN 37343-3298
Phone (423) 645-7151

Other practice location 2

1001 S George St
York, PA 17403-3676
Phone (717) 812-4090

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210803001798 TN Practitioner - Orthopedic Surgery 2567724370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Physicians Practice LLCGroup PAC ID 2163490319, 33 clinicians

Practice addresses (Care Compare)

719 Cook Dr
Suite 104
Athens, TN 37303-3495
Phone (423) 746-2941

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT016537PAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Physicians Practice LLC CurrentSince Sep 1, 2021 Accepting new patients
Athens Physicians Practice, LLC Orthopaedic Surgery CurrentSince Sep 1, 2021 Accepting new patients
Athens Physicians Practice LLC Past Accepting new patients

Locations

719 Cook Dr
Ste 102
Athens, TN 37303
Phone (423) 745-1277

719 Cook Dr
Ste 104
Athens, TN 37303
Phone (423) 745-9770

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

872 Highway 411 N
Unit G
Etowah, TN 37331
Phone (423) 744-7585

Interoperability endpoints

  • Direct secure messaging: dane.bolton.1@19363.direct.athenahealth.com

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 1

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": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1326434317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10663 MONTGOMERY RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424403",
            "telephone_number": "513-347-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10663 MONTGOMERY RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424403",
            "telephone_number": "513-347-9999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1710 Hourglass Pt",
            "address_purpose": "LOCATION",
            "city": "Hixson",
            "state": "TN",
            "postal_code": "373433298",
            "country_code": "US",
            "telephone_number": "423-645-7151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 S George St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174033676",
            "country_code": "US",
            "telephone_number": "717-812-4090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "DANE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OT016537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, OH

Sources for this page

Verify at the official NPI Registry.