Elissa Ann Bolling, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-06990 Issued in NC

Practice address

13640 Steelecroft Pkwy
Charlotte, NC 28278-7565

Phone

(704) 512-5500

NPI assigned

Dec 21, 2016

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1871038265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 MARSH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091849",
            "telephone_number": "336-414-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 STEELECROFT PKWY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787565",
            "telephone_number": "704-512-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLING",
        "first_name": "ELISSA",
        "middle_name": "ANN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheree Boley, RN,CDE
• Nicole Leigh Bolick, MD
• Devin Todd Bolin, RDH
• Shauna N Boling, PT
• Michael Bollin
• Katherine Isabella Bollinger, DPT
• Skyler Jane Bollinger, MA CCC-SLP
• Joy Rosamond Bolly, LPC
• Sabrina Elsje Bologna, PA-C
• Mohammad R. Bolouri, MD

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.

Verify at the official NPI Registry.