Individual provider Active NPI

Erin Ashley Bolin, NP

  • Family Nurse Practitioner
  • Clover, SC
National Provider Identifier
1407572134
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26665 Issued in SC
Practice address
207 Church St
Clover, SC 29710-1008
Phone
(803) 222-3063
NPI assigned
Oct 14, 2022
Last updated
Oct 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26665 SC Primary

Addresses

Primary practice location

207 Church St
Clover, SC 29710-1008

Mailing address

2782 Threefork Trail
Clover, SC 29710
Phone (803) 579-1756

Other practice location 1

1023 Creekside Medical Dr
York, SC 29745-8624
Phone (803) 684-3738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20230217001759 SC Practitioner - Nurse Practitioner 0446622583 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26665SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Physician Network LLC Family CurrentSince Dec 12, 2022 Accepting new patients
Carolina Essential Wellness Past Accepting new patients

Locations

207 Church St
Clover, SC 29710
Phone (803) 222-3063

200 Herlong Ave S
Ste E
Rock Hill, SC 29732
Phone (803) 324-1950

1023 Creekside Medical Dr
York, SC 29745
Phone (803) 684-3730

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14929/brand/3/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1407572134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2782 THREEFORK TRAIL",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "29710",
            "telephone_number": "803-579-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 CHURCH ST",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297101008",
            "telephone_number": "803-222-3063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1023 Creekside Medical Dr",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "SC",
            "postal_code": "297458624",
            "country_code": "US",
            "telephone_number": "803-684-3738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLIN",
        "first_name": "ERIN",
        "middle_name": "ASHLEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "26665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clover, SC

Sources for this page

Verify at the official NPI Registry.