Jennifer Chism Bolen, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F08191029 Issued in MS

Practice address

5482 Ms-15
Ecru, MS 38841

Phone

(662) 488-8799

NPI assigned

Sep 23, 2019

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 MS

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Redmed LLC 54 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Redmed, LLC

  • Urgent Care Clinic/Center
  • Pontotoc, MS
  • NPI 1437589157

  MS

  Medicare reassignment Care Compare group NPD
• Physicians Urgent Care of Corinth, LLC

  • General Practice Physician
  • Corinth, MS
  • NPI 1316059405

  MS

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  MS

  Medicare reassignment NPD
• Redmed, LLC

  • Rural Health Clinic/Center
  • Batesville, MS
  • NPI 1275364424
  Care Compare group
• Redmed, LLC

  • Rural Health Clinic/Center
  • Senatobia, MS
  • NPI 1437980695
  Care Compare group
• Redmed, LLC

  • Rural Health Clinic/Center
  • Oxford, MS
  • NPI 1447081609
  Care Compare group
• Redmed, LLC

  • Rural Health Clinic/Center
  • New Albany, MS
  • NPI 1609607860
  Care Compare group
• Redmed, LLC

  • Rural Health Clinic/Center
  • Pontotoc, MS
  • NPI 1962233122
  Care Compare group
• Redmed, LLC

  • Rural Health Clinic/Center
  • Fulton, MS
  • NPI 1982435145
  Care Compare group
• Physicians Urgent Care of Corinth, LLC

  • Durable Medical Equipment & Medical Supplies
  • Booneville, MS
  • NPI 1942032297
  NPD
• Redmed, LLC

  • Durable Medical Equipment & Medical Supplies
  • Oxford, MS
  • NPI 1679305031
  NPD

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1639720550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5482 MS-15",
            "city": "ECRU",
            "state": "MS",
            "postal_code": "38841",
            "telephone_number": "662-488-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5482 MS-15",
            "city": "ECRU",
            "state": "MS",
            "postal_code": "38841",
            "telephone_number": "662-488-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLEN",
        "first_name": "JENNIFER",
        "middle_name": "CHISM",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "F08191029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allymed, Inc
• Katie Antle, FNP-C
• Athletico LTD
• Michael L Atkeison
• Allison Miller Bailey, CFNP
• Church Street Manor Assisted Living, Inc.
• Felicia Daniel, FNP-BC
• Sabrina Davidson, FNP
• Tracey Michelle Foreman, FNP
• Friendship Medical Clinic, LLC

• All providers in Ecru, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.