Thomas Richard Bolt, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10991 Issued in SC

Practice address

9313 Medical Plaza Drive
Ste 202
N Charleston, SC 29406

Phone

(843) 572-1200

Fax

(843) 553-0424

NPI assigned

Apr 27, 2006

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Family Practice

Education

Medical University of South Carolina College of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palmetto Primary Care Physicians LLCGroup PAC ID 4880508068, 148 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Homestead Hospice of Charleston, LLC Hospice, Summerville, SC, CCN 421631
• Trident Medical Center Hospital, Charleston, SC, CCN 420079

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 35)

Interoperability endpoints

• Direct secure messaging: thomas.bolt@ppcp1.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/CGJJCA

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.

• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1073234928
  Medicare reassignment Care Compare group NPD
• Palmetto Primary Care Physicians

  • Family Medicine Physician
  • Moncks Corner, SC
  • NPI 1104866623
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Daniel Island, SC
  • NPI 1144269929
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1285673269
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1366123739
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1497075733
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Bonneau, SC
  • NPI 1659311165
  NPD
• Homestead Hospice of Charleston, LLC

  • Community Based Hospice Care Agency
  • Summerville, SC
  • NPI 1003209693

  Family Medicine

  NPD (past)

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

• Trident Medical Center, LLC

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937
  Care Compare affiliation

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1639136377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9313 MEDICAL PLAZA DRIVE",
            "address_2": "STE 202",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "29406",
            "telephone_number": "843-572-1200",
            "fax_number": "843-553-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLT",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "10991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109910",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD #",
            "identifier": "080093457",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thaddeus John Bell, MD
• Donald E Bellebaum, D.D.S.
• Bennett Chiropractic Center
• Antionette Akia Bennett, MD
• Timothy C Bennett, D.O.C
• Bon Secours St Francis Xavier Hospital, Inc.
• Bon Secours St. Francis Xavier Hosptial, Inc.
• Mary Heather Bond, ATC
• Ronald Frank Boneberg
• Hunter Bowie, PT

• Family Medicine Physician in N Charleston, SC
• Providers in N Charleston, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.