Active NPI
Bryant Oliver Bolds II, MD, MBA
- Anesthesiology Physician
- Augusta, GA
National Provider Identifier
1871332007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 16298
- Practice address
- 1459 Laney Walker Blvd
Augusta, GA 30912-0002 - Phone
- (706) 721-7005
- NPI assigned
- May 20, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 16298 | GA | Primary |
Addresses
Primary practice location
1459 Laney Walker Blvd
Augusta, GA 30912-0002
Mailing address
2251 Tucker Mill Rd SW
Conyers, GA 30094-3335
Phone (678) 428-1834
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240722002757 | GA | Order and Referring Only - Anesthesiology | 4183160583 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16298 | GA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical College of Georgia | Current | Accepting new patients |
Locations
1459 Laney Walker Blvd
Augusta, GA 30912
Phone (706) 721-2423
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Augusta, GA
- NPI 1891680385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1871332007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2251 TUCKER MILL RD SW",
"city": "CONYERS",
"state": "GA",
"postal_code": "300943335",
"telephone_number": "678-428-1834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1459 LANEY WALKER BLVD",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120002",
"telephone_number": "706-721-7005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDS",
"first_name": "BRYANT",
"middle_name": "OLIVER",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "MD, MBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-20",
"last_updated": "2024-05-20",
"certification_date": "2024-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "GA",
"license": "16298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.