John J Bollig, M.D.
Individual provider Active NPI Family Medicine Physician · Goode, VA
NPI 1720031487 · NPPES record last updated Dec 2, 2025
Key facts
- NPI
- 1720031487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101259534 (VA)
- Practice address
- 1509 Heathwood Dr
Goode, VA 24556-2678 - Phone
- (618) 521-5711
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- 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, LLC
Practice addresses (Care Compare)
2400 Lee Hwy N
Pulaski, VA 24301-2326
Phone (540) 994-8100
Hospital & facility affiliations
- Lewisgale Hospital Pulaski
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160630001397 | VA | Practitioner - Emergency Medicine | 1153379474 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101259534 | VA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kingsford Physician Services, LLC | Single Specialty | Current |
Accepting new patients |
| Privia Medical Group, LLC | Current |
Accepting new patients | |
| Kingsford Emergency Group, LLC | Single Specialty | Current |
Accepting new patients |
| Ingleside Emergency Group, LLC | Single Specialty | Current |
Accepting new patients |
| Privia Medical Group, LLC | Single Specialty | Current |
Accepting new patients |
| Cherokee Indian Hospital Authority | Single Specialty | Past | Accepting new patients |
| Cherokee Indian Hospital Authority | Single Specialty | Past | Accepting new patients |
| Highland Emergency Physicians, PLLC | Single Specialty | Past | Accepting new patients |
| Yates Emergency Physicians | 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 0101259534 | VA | |
| Family Medicine Physician |
207Q00000X | 0101259534 | VA | Yes |
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
Other providers in Goode, VA
- A. R. Hendricksen, D.D.S., Inc.
- Heather Aldridge
- BWJ Dentistry, PLLC
- A. R. Hendricksen
- Holcomb Consulting LLC
- J&K Home Care Inc.
- Kelly Etemadipour Koppenal
All providers in Goode, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.