William Spencer Bolt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5238 Issued in TN

Practice address

1390 5TH St
Jellico, TN 37762-2631

Phone

(931) 253-1110

NPI assigned

Nov 4, 2022

Sex

Male

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

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865

  TN

  Medicare reassignment Care Compare group NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  TN

  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  Care Compare group NPD
• Fast Pace Medical Clinic PLLC

  • Urgent Care Clinic/Center
  • Lincoln, AL
  • NPI 1023773322
  Care Compare group
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Jackson, AL
  • NPI 1033890132
  Care Compare group
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Lincoln, AL
  • NPI 1043975345
  Care Compare group
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Sylacauga, AL
  • NPI 1043975402
  Care Compare group
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Clanton, AL
  • NPI 1215761341
  Care Compare group
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Enterprise, AL
  • NPI 1265114094
  Care Compare group
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Centerville, AL
  • NPI 1336804772
  Care Compare group
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Florence, AL
  • NPI 1639679962
  Care Compare group
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Hanover, IN
  • NPI 1649770769
  Care Compare group

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1891402103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 5TH ST",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377622631",
            "telephone_number": "931-253-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 5TH ST",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377622631",
            "telephone_number": "931-253-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLT",
        "first_name": "WILLIAM",
        "middle_name": "SPENCER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Ann Asante, FNP, PMHNP
• Associates in Eye Care, Inc.
• John Walter Baird, R.PH.
• Deana Barton, APRN
• Bishofberger Medical Associates of East Tennessee
• Allison Jill Branam, PA-C
• Jonathan Broyles, PHARM D
• Charles H. Wilkens, M.D.,P.C.
• Roxanna Chitwood
• Austin Corey

• All providers in Jellico, TN
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.