Anna L Bolha, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2971-023 Issued in WI

Practice address

1200 John Q Hammons Dr Ste 400
Madison, WI 53717-1967

Phone

(608) 410-2700

Fax

(608) 410-2905

NPI assigned

Jul 16, 2012

Last updated

Dec 16, 2020By 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 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1528313681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 JOHN Q HAMMONS DR STE 400",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171967",
            "telephone_number": "608-410-2700",
            "fax_number": "608-410-2905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 JOHN Q HAMMONS DR STE 400",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171967",
            "telephone_number": "608-410-2700",
            "fax_number": "608-410-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLHA",
        "first_name": "ANNA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2971-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528313681",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1200 John Q Hammons Dr Ste 400",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537171967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abolha258789@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "abolha258789@direct-ehr-ssmhc.com",
            "address_1": "1200 John Q Hammons Dr Ste 400",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537171967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lamin Bojang
• Matida Bojang, MD
• Thomas Brendan Boland, MD
• Jacy Renee Boldebuck, MSW
• Jilaine M. Bolek Berquist, M.D.
• Valerie A Boll, NP
• Karen Bollefer, LPN
• Nicole Bollenbacher
• John Craig Bolles, MD
• Kristen Bolles, RN

• Physician Assistant in Madison, WI
• Providers in Madison, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.