Lanny Clarice Bolling, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P2824 Issued in TN

Practice address

101 Med Tech Pkwy Ste 200
Johnson City, TN 37604-4001

Phone

(423) 232-6120

Fax

(423) 232-6125

NPI assigned

Mar 14, 2007

Last updated

Jul 20, 2023By 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

Other names 1

• Ms. Lanny Clarice Bolling Other name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialists in Pain Management, PLLC Dba Spine and Pain AssociatesGroup PAC ID 1355253659, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lanny.bolling.1@30188.direct.athenahealth.com

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.

• Specialists in Pain Management, PLLC Dba Spine & Pain Associates

  • Interventional Pain Medicine Physician
  • Chattanooga, TN
  • NPI 1447203922
  Medicare reassignment Care Compare group NPD
• Pain Medicine Associates, P.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Johnson City, TN
  • NPI 1477594364
  Medicare reassignment NPD
• Pain Medicine Associates, P.C.

  • Psychologist
  • Johnson City, TN
  • NPI 1962655696
  NPD
• Specialists in Pain Management, PLLC Dba Spine & Pain Associates

  • Prosthetic/Orthotic Supplier
  • Cleveland, TN
  • NPI 1134872922
  NPD
• Crossroads Integrated Health Services, Inc.

  • Clinical Psychologist
  • Morristown, TN
  • NPI 1144429705
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1578696944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W SUMMIT HILL DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379021025",
            "telephone_number": "865-525-1099",
            "fax_number": "865-525-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MED TECH PKWY STE 200",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044001",
            "telephone_number": "423-232-6120",
            "fax_number": "423-232-6125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 Kentucky Ave",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376203815",
            "country_code": "US",
            "telephone_number": "865-591-9167",
            "fax_number": "423-232-6125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLING",
        "first_name": "LANNY",
        "middle_name": "CLARICE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P2824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)",
            "identifier": "103I681458",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LANNY",
            "last_name": "BOLLING",
            "middle_name": "CLARICE",
            "prefix": "MS.",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Savannah R Boles, RT(R)(MR)RN
• Richard Alexander Boleyn, D.C.
• Richard A Bolinger, PT
• Alexis Bolling
• Gabriel Bolling, LCSW
• Bolt Eye Group - Johnson City, LLC
• Katie Bolton
• Rhonda Jean Bolton, M.S. CCC-SLP
• Brian R Bonfardin, MD
• Nicole Raastad Bonham, MA

• Clinical Psychologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.