Individual provider Active NPI

Kim P Bolton, MD

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1558376608
Registry record updated Apr 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J9980 Issued in TX
Practice address
6835 Austin Center Blvd
Austin, TX 78731-3166
Phone
(512) 346-6611
Fax
(512) 231-5203
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J9980 TX Primary

Addresses

Primary practice location

6835 Austin Center Blvd
Austin, TX 78731-3166

Mailing address

PO Box 26726
Austin, TX 78755-0726
Phone (512) 407-8686

Other identifiers 3

IdentifierTypeStateIssuer
118464004MedicaidTX
080146949MedicaidTX
118464003MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080204000239 TX Practitioner - Family Practice 4385726066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Johns Hopkins University School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

10401 Anderson Mill Rd
Suite 110B
Austin, TX 78750-2579
Phone (512) 250-5571

12201 Renfert Way
250 Austin Regional Clinic North Austin OB/
Austin, TX 78758-5354
Phone (512) 994-2662

151 Exchange Blvd
500 Arc Hutto
Hutto, TX 78634-5381
Phone (512) 846-1244

6835 Austin Ctr Blvd
Austin, TX 78731-3166
Phone (512) 346-6611

801 E Whitestone Blvd BLDG C
Arc Cedar Park
Cedar Park, TX 78613-7558
Phone (512) 259-3467

901 Crystal Falls Pkwy
Suite 103
Leander, TX 78641-1931
Phone (512) 259-2198

940 Hesters Crossing Rd
Round Rock, TX 78681-8018
Phone (512) 244-9024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA CurrentSince Jan 3, 2000 Accepting new patients
Austin Regional Clinic, PA Family Medicine CurrentSince Jan 3, 2000 Accepting new patients
Austin Regional Clinic, PA Past Accepting new patients
Seton Hospitalist Service Past Accepting new patients

Locations

4515 Seton Center Pkwy
Ste 215
Austin, TX 78759
Phone (512) 338-3802

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

Interoperability endpoints

  • Direct secure messaging: kbolton12749@arcmd.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270166400000",
    "number": "1558376608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26726",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787550726",
            "telephone_number": "512-407-8686",
            "fax_number": "512-421-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6835 AUSTIN CENTER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313166",
            "telephone_number": "512-346-6611",
            "fax_number": "512-231-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "KIM",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2010-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J9980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118464004",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080146949",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118464003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.