Gary Eugene Bolen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH7387 Issued in FL

Practice address

4107 South Tamiami Trail
Venice, FL 34293

Phone

(941) 497-7424

Fax

(941) 493-8413

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1996

Medicare assignment

May accept Medicare assignment

Group practices

Venice Village Chiropractic Clinic PAGroup PAC ID 9133219470, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Venice Village Chiropractic Clinic PA

  • Chiropractor
  • Venice, FL
  • NPI 1033302492
  Medicare reassignment Care Compare group NPD Authorized official
• Treco Wellness Inc

  • Chiropractor
  • Venice, FL
  • NPI 1639576812
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467568816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 SOUTH TAMIAMI TRAIL",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "34293",
            "telephone_number": "941-497-7424",
            "fax_number": "941-493-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 SOUTH TAMIAMI TRAIL",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "34293",
            "telephone_number": "941-497-7424",
            "fax_number": "941-493-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLEN",
        "first_name": "GARY",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Sky Mining Company LLC
• Frank Blum
• Brieanna M Blumenstein, ARNP
• Mary Michelle Bogen, DPM
• Socheatra P Bokach, P.A.C
• Cameron Jennay Boles, LMHC
• Robert Bolton, DDS MS
• Jennifer Michelle Bomalaski
• Matthew J Bonanno, MD
• Kirsten Bond

• Chiropractor in Venice, FL
• Providers in Venice, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.