Jennifer Lynn Bolan, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

35.098053 Issued in OH

Practice address

903 NW Washington Blvd Ste a
Hamilton, OH 45013-6367

Phone

(513) 454-1111

NPI assigned

Jan 7, 2008

Last updated

Aug 18, 2021By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Obstetrics/Gynecology

Education

Wright State University Boonshoft School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Five Rivers Health CentersGroup PAC ID 9335300904, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.frey.p5@direct.phs.nextgenshare.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.

• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1669143061
  Medicare reassignment Care Compare group
• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1053600775
  NPD
• Five Rivers Health Centers

  • Family Medicine Physician
  • Xenia, OH
  • NPI 1083501415

  Obstetrics & Gynecology

  NPD
• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1851934525
  NPD

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1790960953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HIGH ST FL 4",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450116078",
            "telephone_number": "513-454-1460",
            "fax_number": "513-863-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 NW WASHINGTON BLVD STE A",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450136367",
            "telephone_number": "513-454-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 S 2nd St",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450112811",
            "country_code": "US",
            "telephone_number": "513-454-1111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1036 S Verity Pkwy",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450445513",
            "country_code": "US",
            "telephone_number": "513-454-1460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLAN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35.098053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054909",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.frey.p5@direct.phs.nextgenshare.com",
            "affiliation": "N",
            "address_1": "903 NW Washington Blvd Ste A",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450136367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Olivia Boch, ED.S.
• Lindsey Bockerstette
• Laura Bohman, SLP
• Darla Boitnott, LCDC-II
• Nour Ilenda Bokatuka
• Ashley Bolce, LSW
• Emily B Bolen
• Samuel Bolen
• Ellen Bolinger
• Amy Marie Bonham, REGISTERED NURSE

• Obstetrics & Gynecology Physician in Hamilton, OH
• Providers in Hamilton, OH by specialty
• Obstetrics & Gynecology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.