Ryschell Renee Bolton, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

125.052729 Issued in IL

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Phone

(817) 689-5523

NPI assigned

Jul 13, 2007

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

Specialty

Emergency Medicine

Education

University of North Texas HSC, College of Osteopathic Med, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Medicine Resources, LLPGroup PAC ID 5890688212, 255 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Texas Medicine Resources, LLP

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1376581900
  Medicare reassignment Care Compare group NPD
• Texas Physician Resources, LLP

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1639413289
  Medicare reassignment NPD

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

• Texas Health Harris Methodist Hospital Southwest Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1417980202
  Care Compare affiliation

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1689873234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11217 N OAKWOOD DR",
            "address_2": "UNIT 57",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151038",
            "telephone_number": "817-689-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "817-689-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "RYSCHELL",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.052729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Bohm, DO
• Andrew Bokus, CRNA
• Allison Boley
• Thomas Joseph Bollaert, MD
• Joshua Bolliger, CRNA
• Colin Neil Bomstad, MD
• Bond Eye Associates, S.C.
• Glenn Bond
• Julius P. Bonello, M.D.
• Michael J Bonham, RPH

• Emergency Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; 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.