Stephen Bolivar, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

888641 Issued in MS

Practice address

401 Southcrest Cir Ste 202
Southaven, MS 38671-6719

Phone

(662) 536-2281

Fax

(901) 763-3694

NPI assigned

Aug 29, 2013

Last updated

Sep 3, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS, TN2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206

  MS

  Medicare reassignment Care Compare group NPD
• South Central Clinics, Inc

  dba Ellisville Medical Clinic

  • Family Medicine Physician
  • Ellisville, MS
  • NPI 1801226287
  Medicare reassignment NPD
• South Central Clinics, Inc

  dba South Central Urgent Care

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1033903547
  NPD
• South Central Clinics, Inc.

  dba OB Group of Laurel

  • Obstetrics & Gynecology Physician
  • Laurel, MS
  • NPI 1942240510
  NPD
• Baptist Memorial Medical Group Inc

  dba BMG East Memphis Pharmacy

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1841006129
  NPD
• Baptist Memorial Health Services, Inc. of Mississippi

  • Internal Medicine Physician
  • New Albany, MS
  • NPI 1104971696
  NPD (past)
• Dearman Medical Group, LLC

  dba Jones Family Medicine Clinics

  • Family Medicine Physician
  • Laurel, MS
  • NPI 1609531276
  NPD (past)
• Jones Family Medicine Clinic, PLLC

  dba JFMC The Q, LLC

  • Primary Care Clinic/Center
  • Laurel, MS
  • NPI 1801222898
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1598199291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3158 MEADOWS WAY",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386321090",
            "telephone_number": "601-651-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SOUTHCREST CIR STE 202",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716719",
            "telephone_number": "662-536-2281",
            "fax_number": "901-763-3694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5659 S Rex Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381193821",
            "country_code": "US",
            "telephone_number": "901-763-3636",
            "fax_number": "901-763-3694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8138 Country Village Dr",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380162029",
            "country_code": "US",
            "telephone_number": "901-725-8606",
            "fax_number": "901-759-9254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Southcrest Cir Ste 104",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386716712",
            "country_code": "US",
            "telephone_number": "662-536-2281",
            "fax_number": "662-536-2282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Exeter Rd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383966",
            "country_code": "US",
            "telephone_number": "901-757-1350",
            "fax_number": "901-757-3496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLIVAR",
        "first_name": "STEPHEN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-29",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "888641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07029064",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Southaven, MS
• Providers in Southaven, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; 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.