Sally Jane Fox Bolek, RN, MSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704141458 Issued in MI

Practice address

913 S Clay St
Greenville, MI 48838-2346

Phone

(616) 835-9080

NPI assigned

Feb 18, 2020

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

Practice roles

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.

• Clay Street Center

  • Adult Day Care Clinic/Center
  • Greenville, MI
  • NPI 1487164026
  NPD (past) Authorized official

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1740813757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 S CLAY ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382346",
            "telephone_number": "616-835-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 S CLAY ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382346",
            "telephone_number": "616-835-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX BOLEK",
        "first_name": "SALLY",
        "middle_name": "JANE",
        "credential": "RN, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704141458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brieanna Corynn Fonger
• Maurice Eugene Fongers III, PA-C
• Julie K Ford, MSW
• Kinsley Ann Formsma
• Michael Jared Foster, DO
• Nicole Fox
• Peggy Jo Frank, MA CCC-A
• Shelby J Franklin
• Kaileen Freeberg, OD
• Andrea Hope Curtin Freeman, MD

• Registered Nurse in Greenville, MI
• Providers in Greenville, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.