Virginia Bolan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149020864 Issued in IL

Practice address

701 Devonshire Dr Ste B1
Champaign, IL 61820-7337

Phone

(217) 352-0200

Fax

(217) 607-1139

NPI assigned

Jan 10, 2019

Sex

Female

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 IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Missouri, Kansas City, School of Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1477026607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR STE B1",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207337",
            "telephone_number": "217-352-0200",
            "fax_number": "217-607-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR STE B1",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207337",
            "telephone_number": "217-352-0200",
            "fax_number": "217-607-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAN",
        "first_name": "VIRGINIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149020864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Rodolfo Bocanegra Cordova, PA-C
• Jacqueline Ann Bode, APN
• Bodhi Counseling & Consulting Center, PC
• Jerome Bogan
• Geoffrey Loren Boise
• Jessica Bolger, PA
• Calvin James Bolser
• Latrice Bolton
• Susan G. Bolton, M.D.
• Taaji Bolton, RBT

• Clinical Social Worker in Champaign, IL
• Providers in Champaign, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.