Jacqueline Bolt, MD

Primary specialty

Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X

License

S5563 Issued in TX

Practice address

7601 Preston Rd
Plano, TX 75024-3214

Phone

(469) 303-7000

NPI assigned

Apr 10, 2017

Last updated

Aug 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbolt146168@direct.phhs.org

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.

• Pediatric Emergency Medicine Group LLP

  • Emergency Medicine Physician
  • Plano, TX
  • NPI 1629448535
  Medicare reassignment NPD

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1629501333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 N ZANG BLVD APT 718",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031233",
            "telephone_number": "253-468-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 PRESTON RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243214",
            "telephone_number": "469-303-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLT",
        "first_name": "JACQUELINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "S5563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Michael Bolak, D.M.D.
• Benjamin Jang Bolding, PHARM D
• Andrew C. Bolin, MD
• Shannon C Bolinger, PA
• Lilian Inutu Bollers, LCSW-C, LICSW
• Phil Bome
• Bonafide Steady Home Healthcare
• Amy Michelle Bond, FNP
• Brittany Jane Bond, LPC-ASSOCIATE
• John Bonds, PH.D, DDS

• Pediatric Emergency Medicine (Emergency Medicine) Physician in Plano, TX
• Providers in Plano, TX by specialty
• Pediatric Emergency Medicine (Emergency Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.