Melissa Clark Bolt, LPN

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

T63345963 Issued in VA

Practice address

4138 Mitchell Rd
Ridgeway, VA 24148-4225

Phone

(276) 340-1142

Fax

(276) 956-5050

NPI assigned

Mar 13, 2018

Last updated

Mar 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1376046649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4138 MITCHELL RD",
            "city": "RIDGEWAY",
            "state": "VA",
            "postal_code": "241484225",
            "telephone_number": "276-340-1142",
            "fax_number": "276-956-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4138 MITCHELL RD",
            "city": "RIDGEWAY",
            "state": "VA",
            "postal_code": "241484225",
            "telephone_number": "276-340-1142",
            "fax_number": "276-956-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLT",
        "first_name": "MELISSA",
        "middle_name": "CLARK",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "VA",
            "license": "T63345963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makunda Abdul-Mbacke, MD
• Clyde Walcey Burris, III III, D.D.S.
• Joanna Lynn Carter, FNP-C
• Chan M Park Family Practice
• Clyde Walcey Burris, III, D.D.S., P.C.
• Community Alternatives Virginia, Inc.

• Non-emergency Medical Transport (VAN) in Ridgeway, VA
• Providers in Ridgeway, VA by specialty
• Non-emergency Medical Transport (VAN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.