NPIMap

Individual provider Active NPI

Breanna Keenan Bolivar, M.D., MPH

  • Obstetrics & Gynecology Physician
  • Asheville, NC
National Provider Identifier
1477817013
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2014-02009 Issued in NC
Practice address
119 Hendersonville Rd
Asheville, NC 28803-2868
Phone
(828) 771-5500
Fax
(828) 257-4750
NPI assigned
Jun 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 2014-02009 NC
Gynecology Physician 207VG0400X 2014-02009 NC
Obstetrics & Gynecology Physician 207V00000X 2014-02009 NC Primary

Addresses

Primary practice location

119 Hendersonville Rd
Asheville, NC 28803-2868

Mailing address

119 Hendersonville Rd
Asheville, NC 28803-2868
Phone (828) 771-5000

Other identifiers 2

IdentifierTypeStateIssuer
NCT347AOtherNCPTAN
1477817013MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803003094 NC Practitioner - Obstetrics/Gynecology 2567611106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wright State University Boonshoft School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Area Health Education Center Inc 156 clinicians

Practice addresses (Care Compare)

119 Hendersonville Rd
Asheville, NC 28803-2868
Phone (828) 771-5500

Hospital & facility affiliations

  • Memorial Mission Hospital and Asheville Surgery Ce Hospital, Asheville, NC, CCN 340002

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as apm
Quality
77.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2014-02009NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Area Health Education Center, Inc. Obstetrics & Gynecology Current Accepting new patients
Mountain Area Health Education Center, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Mountain Area Health Education Center, Inc. Current Accepting new patients

Locations

19 N Ann St
Asheville, NC 28801
Phone (828) 252-8883

125 Hendersonville Rd
Asheville, NC 28803
Phone (828) 579-2100

600 Barrett Ln
Asheville, NC 28803
Phone (828) 271-6946

218 Elkwood Ave
Ste 102
Asheville, NC 28804
Phone (828) 257-4747

119 Hendersonville Rd
Biltmore Forest, NC 28803
Phone (828) 771-5500

87 Medical Park Dr
Ste B
Brevard, NC 28712
Phone (828) 547-3004

25 Westridge Market Pl
Candler, NC 28715
Phone (443) 865-4662

1542 Cane Creek Rd
Fletcher, NC 28732
Phone (828) 628-8250

56 Medical Park Dr
Franklin, NC 28734
Phone (828) 349-8280

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1477817013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 HENDERSONVILLE RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288032868",
            "telephone_number": "828-771-5000",
            "fax_number": "828-257-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 HENDERSONVILLE RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288032868",
            "telephone_number": "828-771-5500",
            "fax_number": "828-257-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIVAR",
        "first_name": "BREANNA",
        "middle_name": "KEENAN",
        "credential": "M.D., MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NC",
            "license": "2014-02009",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NC",
            "license": "2014-02009",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2014-02009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "NCT347A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477817013",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.