Jeffrey Karl Bosold, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A01909 Issued in AR

Practice address

3812 West Main
Russellville, AR 72801

Phone

(479) 968-1245

Fax

(479) 968-4137

NPI assigned

Jun 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Westside Family Clinic LLCGroup PAC ID 3476915372, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Care IV Home Health Home health agency, Russellville, AR, CCN 047173
• St Marys Regional Medical Center Hospital, Russellville, AR, CCN 040041

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DDAJAD

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.

• Westside Family Clinic LLC

  • Family Nurse Practitioner
  • Russellville, AR
  • NPI 1801587779

  AR, Family

  Medicare reassignment Care Compare group NPD Authorized official
• East Arkansas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Blytheville, AR
  • NPI 1932442985

  AR, Nurse Practitioner

  Medicare reassignment NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  AR, Nurse Practitioner

  Medicare reassignment NPD
• Monfee Medical Clinic

  • Family Medicine Physician
  • Russellville, AR
  • NPI 1154350213

  AR

  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Care IV, Inc.

  • Home Health Agency
  • Russellville, AR
  • NPI 1235149212
  Care Compare affiliation
• Care IV, Inc.

  • Home Health Agency
  • Little Rock, AR
  • NPI 1275520652
  Care Compare affiliation
• Russellville Holdings LLC

  • General Acute Care Hospital
  • Russellville, AR
  • NPI 1033160049

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1396941522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10185",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728120185",
            "telephone_number": "479-968-5748",
            "fax_number": "479-968-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 WEST MAIN",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-968-1245",
            "fax_number": "479-968-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSOLD",
        "first_name": "JEFFREY",
        "middle_name": "KARL",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A001909",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A01909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Bobo, RECOVERY ASSISTANT
• Kenna Bondoc, COTA
• Bonds Family Dentistry, Inc
• James Dustin Bonds, DDS
• Yariela Borras, CM
• Alicia M Bost, M.S.O.T.R.L.
• Stacey Marie Boster, MS,PT
• Timothy Isaac Bostick, CASE MANAGER PARAPRO
• Tommy Bourgeois, CASE MANAGER CARE CO
• Nicole Anne Bovkoon

• All providers in Russellville, AR
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.