Susan Marie Bollman, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71009390A Issued in IN

Practice address

1002 Wishard Blvd
Indianapolis, IN 46202-2872

Phone

(317) 944-4846

NPI assigned

Sep 10, 2019

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sbollman@direct.iuhealth.org

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.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  NPD (past)
• University Pediatric Associates, Inc.

  • Pediatrics Physician
  • Indianapolis, IN
  • NPI 1457396541
  NPD (past)

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1992354104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1026",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061026",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 WISHARD BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022872",
            "telephone_number": "317-944-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLMAN",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71009390A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300030679",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Boling, D.O
• Stephanie Marie Bolivar, MD
• Prashanthi Reddy Bolla, M.D.
• Linda Boller
• Nancy Jane Bollinger, PT
• Rebecca P Bolon, DDS MSD
• Alan L. Bolotin, LCSW
• Lucas Bolt, NP
• Achaia Zsavon Bolton, BS, RBT
• Cherish Bolton, MSW, LSW

• Pediatric Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.