Individual provider Active NPI

Jessica Marie Bolano, APRN, FNP-BC

  • Family Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1619714151
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
120342 Issued in WV
Practice address
1249 15TH Street
Suite 3000
Huntington, WV 25701-3663
Phone
(304) 691-1000
Fax
(304) 691-1693
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 120342 WV Primary

Addresses

Primary practice location

1249 15TH Street
Suite 3000
Huntington, WV 25701-3663

Mailing address

1448 10TH Avenue
Suite 304
Huntington, WV 25701-3579
Phone (304) 691-6381

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jessica.bolano@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241211002005 WV Practitioner - Nurse Practitioner 9830625011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1249 15TH St
Suite 3000
Huntington, WV 25701-3663
Phone (304) 691-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc. CurrentSince Sep 9, 2024 Accepting new patients
St. Mary's Medical Management, LLC Family CurrentSince Jan 15, 2026 Accepting new patients
St. Mary's Medical Management, LLC CurrentSince Jan 15, 2026 Accepting new patients
University Physicians & Surgeons, Inc Family CurrentSince Sep 9, 2024 Accepting new patients

Locations

3075 US Route 60
Huntington, WV 25705
Phone (304) 733-0004

1249 15th St
Ste 2000
Huntington, WV 25701
Phone (304) 691-1086

1448 10th Ave
Ste 304
Huntington, WV 25701
Phone (304) 691-6381

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

1249 15th St
Ste 3000
Huntington, WV 25701
Phone (304) 691-1095

Interoperability endpoints

  • Direct secure messaging: jessica.bolano@marshall.cernerdirect.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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1619714151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 10TH AVENUE",
            "address_2": "SUITE 304",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013579",
            "telephone_number": "304-691-6381",
            "fax_number": "304-691-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 15TH STREET",
            "address_2": "SUITE 3000",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013663",
            "telephone_number": "304-691-1000",
            "fax_number": "304-691-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANO",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "120342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.bolano@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1249 15th Street",
            "address_2": "Suite 3000",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.