Marie D Bolivar-Cano, DNP, ACNP-BC, CEN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024172352 Issued in VA

Practice address

3900 Woodland Ave
Philadelphia, PA 19104

Phone

(215) 823-6004

NPI assigned

Jun 21, 2006

Last updated

Jun 3, 2018By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• 24 Ihim LLC

  • Internal Medicine Physician
  • Melrose Park, IL
  • NPI 1730251083
  NPD (past)
• Inphynet Contracting Services LLC

  • Emergency Medicine Physician
  • Delray Beach, FL
  • NPI 1073556767

  Nurse Practitioner

  NPD (past)
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459

  Nurse Practitioner

  NPD (past)
• University of Alabama at Birmingham

  dba UAB Emergency Department

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1407837750
  NPD (past)
• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1447145818
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527984000000",
    "number": "1518903152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-823-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIVAR-CANO",
        "first_name": "MARIE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DNP, ACNP-BC, CEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024172352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SOUTH",
            "identifier": "1518903152",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891010870",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "515-99504",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112913",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Renee Bolding, LPC
• Patricia Boldt
• Megan Bolger, LCMHCA
• Melissa Marie Bolick, DO
• Sara Bolivar Wagers, MD/PHD
• Anna Elizabeth Bollag, DMD, MS
• Lauren Bollenback, DMD
• Kassie Jean Bollig, MD
• Bridgett Bollin, MSW, LCSW
• Christopher Bollinger, OTR/L

• Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.