Tammy M Bolles, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW13585 Issued in FL

Practice address

1708 Old River TRL.
Chuluota, FL 32766-3276

Phone

(305) 781-1682

Fax

(305) 781-1682

NPI assigned

Jan 16, 2018

Last updated

Jan 16, 2018By 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 FL, TN2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Doctor on Demand Professionals P CGroup PAC ID 9436464567, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tammy.bolles.1@30520.direct.athenahealth.com

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.

• Doctor on Demand Professionals P C

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1174931448

  FL, TN

  Medicare reassignment Care Compare group NPD
• Ehome Behavioral Care

  • Professional Counselor
  • Orlando, FL
  • NPI 1538609003

  Clinical

  Medicare reassignment NPD
• Beyond the Scars Therapy LLC

  • Clinical Social Worker
  • Chuluota, FL
  • NPI 1093440844
  NPD Authorized official

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1669980439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 OLD RIVER TRL",
            "city": "CHULUOTA",
            "state": "FL",
            "postal_code": "327668603",
            "telephone_number": "305-781-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 OLD RIVER TRL.",
            "city": "CHULUOTA",
            "state": "FL",
            "postal_code": "327663276",
            "telephone_number": "305-781-1682",
            "fax_number": "305-781-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLES",
        "first_name": "TAMMY",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ajr Loving Care Assisted Living
• Kevin Mason Banks
• Beyond the Scars Therapy LLC
• Engy Kheir Boutros
• Bright Morning Star Assisted Living Facility,Inc (Bright Morning Star Assisted Living,Inc)
• Erica Margaret Carrillo
• Chuluota Clinic, LLC
• Tamara Ciupik

• Clinical Social Worker in Chuluota, FL
• Providers in Chuluota, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; 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.