NPIMap

Individual provider Active NPI

John J Bollig, M.D.

  • Family Medicine Physician
  • Goode, VA
National Provider Identifier
1720031487
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101259534 Issued in VA
Practice address
1509 Heathwood Dr
Goode, VA 24556-2678
Phone
(618) 521-5711
NPI assigned
May 17, 2006
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101259534 VA
Family Medicine Physician 207Q00000X 0101259534 VA Primary

Addresses

Primary practice location

1509 Heathwood Dr
Goode, VA 24556-2678

Mailing address

1509 Heathwood Dr
Goode, VA 24556-2678
Phone (618) 521-5711

Other practice location 1

2400 Lee Hwy N
Pulaski, VA 24301-2326
Phone (540) 994-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160630001397 VA Practitioner - Emergency Medicine 1153379474 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oregon Health Sciences University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kingsford Emergency Group, LLCGroup PAC ID 3870841117, 14 clinicians

Practice addresses (Care Compare)

2400 Lee Hwy N
Pulaski, VA 24301-2326
Phone (540) 994-8100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Single Specialty CurrentSince Jul 21, 2018 Accepting new patients
Ingleside Emergency Group, LLC Single Specialty CurrentSince Sep 8, 2020 Accepting new patients
Kingsford Emergency Group, LLC Single Specialty CurrentSince Oct 4, 2020 Accepting new patients
Privia Medical Group, LLC CurrentSince Jul 21, 2018 Accepting new patients
Kingsford Physician Services, LLC Single Specialty CurrentSince Oct 30, 2020 Accepting new patients
Highland Emergency Physicians, PLLC Single Specialty Past Accepting new patients
Yates Emergency Physicians Single Specialty Past Accepting new patients
Cherokee Indian Hospital Authority Single Specialty Past Accepting new patients
Cherokee Indian Hospital Authority Single Specialty Past Accepting new patients

Locations

1 Arh Ln
Low Moor, VA 24457
Phone (540) 862-6223

8644 Sudley Rd
#220
Manassas, VA 20110

2400 Lee Hwy N
Pulaski, VA 24301
Phone (540) 994-8100

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1720031487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 HEATHWOOD DR",
            "city": "GOODE",
            "state": "VA",
            "postal_code": "245562678",
            "telephone_number": "618-521-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 HEATHWOOD DR",
            "city": "GOODE",
            "state": "VA",
            "postal_code": "245562678",
            "telephone_number": "618-521-5711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Lee Hwy N",
            "address_purpose": "LOCATION",
            "city": "Pulaski",
            "state": "VA",
            "postal_code": "243012326",
            "country_code": "US",
            "telephone_number": "540-994-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLIG",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101259534",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101259534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goode, VA

Sources for this page

Verify at the official NPI Registry.