Active NPI
Heather Diana Bolton, PA
- Physician Assistant
- Lebanon, TN
National Provider Identifier
1831133727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1192
- Practice address
- 307 F West Main St
Lebanon, TN 37087 - Phone
- (615) 449-4151
- Fax
- (615) 449-1994
- NPI assigned
- Jun 15, 2006
- Last updated
- Oct 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1192 | TN | Primary |
Addresses
Primary practice location
307 F West Main St
Lebanon, TN 37087
Mailing address
PO Box 3322
Lebanon, TN 37088
Phone (615) 449-4151
Other names 1
- Mrs. Heather Diana Thompson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1192 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lung Consultants PLLC | Past | Accepting new patients | |
| Agapee Surgical Associates Inc. | Past | Accepting new patients | |
| Lebanon Health Care Center | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Surgery Physician
- Madison, TN
- NPI 1891782637
-
- Pulmonary Disease Physician
- Nashville, TN
- NPI 1174581144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191369600000",
"number": "1831133727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3322",
"city": "LEBANON",
"state": "TN",
"postal_code": "37088",
"telephone_number": "615-449-4151",
"fax_number": "615-449-1994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 F WEST MAIN ST",
"city": "LEBANON",
"state": "TN",
"postal_code": "37087",
"telephone_number": "615-449-4151",
"fax_number": "615-449-1994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTON",
"first_name": "HEATHER",
"middle_name": "DIANA",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2007-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "PA1192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "THOMPSON",
"middle_name": "DIANA",
"prefix": "MRS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lebanon, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.