James Tyler Bolin, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

9639 Issued in KY

Practice address

220 Ruccio Way
Suite 120
Lexington, KY 40503-3584

Phone

(859) 309-1095

NPI assigned

Jun 5, 2013

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 KY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974

  KY

  Medicare reassignment NPD
• University of Kentucky

  • Dentist
  • Lexington, KY
  • NPI 1306929385
  NPD

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1487092029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RUCCIO WAY",
            "address_2": "SUITE 120",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033584",
            "telephone_number": "859-309-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RUCCIO WAY",
            "address_2": "SUITE 120",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033584",
            "telephone_number": "859-309-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIN",
        "first_name": "JAMES",
        "middle_name": "TYLER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-05",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9639",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Gabrielle Bojarski, DO
• Adrienne Boland, LPCA
• Michael Robert Boland, MD
• Ileana Boldo
• William G. Boliek, M.D.
• Mary Chandler Bolin, LIC PSYCHOLOGIST
• Jacquelyn Paige Boling
• Julia Skyla Rose Boling
• Michael Bryan Boling, APRN
• Emma Elise Bolinger

• All providers in Lexington, KY
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.