Individual provider Active NPI

Kimberly Ann Bolling, RN

  • Family Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1962136184
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024184858 Issued in VA
Practice address
2001 Crystal Spring Ave SW Ste 201
Roanoke, VA 24014-2465
Phone
(540) 853-0100
NPI assigned
Jul 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001192587 VA
Family Nurse Practitioner 363LF0000X 0024184858 VA Primary

Addresses

Primary practice location

2001 Crystal Spring Ave SW Ste 201
Roanoke, VA 24014-2465

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5715

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kabolling@carilionclinic.org

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220919002089 VA Practitioner - Nurse Practitioner 0244615870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

2001 Crystal Spring Ave
Suite 201
Roanoke, VA 24014-2472
Phone (540) 982-7618

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001192587VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Oct 24, 2022 Accepting new patients
Carilion Medical Center CurrentSince Oct 24, 2022 Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

2001 Crystal Spring Ave SW
Ste 201
Roanoke, VA 24014
Phone (540) 853-0100

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

Interoperability endpoints

  • Direct secure messaging: kbolling12998@direct.carilionclinic.org

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1962136184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5715",
            "fax_number": "540-224-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 CRYSTAL SPRING AVE SW STE 201",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142465",
            "telephone_number": "540-853-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLING",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001192587",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024184858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kabolling@carilionclinic.org",
            "affiliation": "N",
            "endpointDescription": "Carilion email",
            "address_1": "2001 Crystal Spring Ave SW Ste 201",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240142465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.