Individual provider Active NPI

James Aaron Bolton, D.O.

  • Family Medicine Physician
  • Lockport, NY
National Provider Identifier
1861848392
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-1259 Issued in ID
Practice address
521 East Ave
Lockport, NY 14094-3201
Phone
(716) 514-1233
NPI assigned
May 13, 2016
Last updated
May 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X O-1259 ID Primary

Addresses

Primary practice location

521 East Ave
Lockport, NY 14094-3201

Mailing address

521 East Ave
Lockport, NY 14094-3201

Other practice location 1

267 N Canyon Dr
Gooding, ID 83330-5500
Phone (208) 934-4433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20190705000423 ID Practitioner - Family PracticePractitioner - General Practice 9234464769 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Canyon Medical Center IncGroup PAC ID 0941371439, 73 clinicians

Practice addresses (Care Compare)

267 N Canyon Dr
Gooding, ID 83330-5500
Phone (208) 934-4433

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Canyon Medical Center Inc. CurrentSince Jul 31, 2019 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Jul 31, 2019 Accepting new patients
Inland Cardiology Associates, P.S. Past Accepting new patients

Locations

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

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.

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": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1861848392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 EAST AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140943201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 EAST AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140943201",
            "telephone_number": "716-514-1233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "267 N Canyon Dr",
            "address_purpose": "LOCATION",
            "city": "Gooding",
            "state": "ID",
            "postal_code": "833305500",
            "country_code": "US",
            "telephone_number": "208-934-4433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "JAMES",
        "middle_name": "AARON",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-13",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

Verify at the official NPI Registry.