BOLIVAR PHYSICIAN PRACTICES LLC (NPI# 1205489689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205489689 |
| Entity Type | Organization |
| Organization Name | BOLIVAR PHYSICIAN PRACTICES LLC |
| Practice Address |
512 Levee St Rosedale MS 38769-5507 |
| Mailing Address |
330 Seven Springs Way Brentwood TN 37027-5098 |
| Practice Telephone | 6627596806 |
| Practice Fax Number | 6627596771 |
| Mailing Telephone | 6159207000 |
| Mailing Fax Number | 6159208775 |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2019-07-24 |
| Authorized Official Name | KATHY TEAGUE (SECRETARY) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Rosedale Family Medical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386076800 | Bolivar Physician Practices LLC | Otolaryngology | 903 E Sunflower Rd, Suite 400, Cleveland, MS 38732-2835 | 2013-08-07 |
| 1629379078 | Bolivar Physician Practices LLC | Psychiatry & Neurology | 903 East Sunflower Rd, Suite 400, Cleveland, MS 38732-2551 | 2010-11-16 |
| 1376787556 | Bolivar Physician Practices LLC | Family Medicine | 218 N Pearman Ave, Cleveland, MS 38732-2634 | 2009-05-01 |
| 1316388416 | Bolivar Physician Practices LLC | Urology | 907 E Sunflower Rd, Suite 103, Cleveland, MS 38732-2830 | 2013-07-17 |
| 1043454655 | Bolivar Physician Practices LLC | Internal Medicine | 810 E Sunflower Rd, Ste. 100a, Cleveland, MS 38732-2800 | 2009-04-27 |
| 1063659530 | Bolivar Physician Practices LLC | Orthopaedic Surgery | 907 E Sunflower Rd, Suite 102, Cleveland, MS 38732-2830 | 2009-01-20 |
| Street Address |
512 LEVEE ST |
| City | ROSEDALE |
| State | MS |
| Zip Code | 38769-5507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215068630 | Joel D Gibson | Dentist | 512 Levee St, Rosedale, MS 38769 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629270871 | Angel of Mercy Hospice | Hospice Care, Community Based | 314 S Court St, Rosedale, MS 38769 | 2007-06-01 |
| 1477575561 | Brooke Nicole Tims | Nurse Practitioner | 512 Levee Street, Rosedale, MS 38769 | 2006-07-24 |
| 1144548645 | Joy's Loving Care Adult Daycare Center | Day Training, Developmentally Disabled Services | 906 Main Street, Rosedale, MS 38769 | 2010-05-07 |
| 1912057704 | West Bolivar School District | Public Health or Welfare | 1212 South Main Street, Rosedale, MS 38769-0159 | 2007-01-12 |
| 1154651040 | West Bolivar School District | Local Education Agency (LEA) | Highways 1 & 8, Rosedale, MS 38769-0189 | 2009-12-28 |
| 1720377641 | Leigh Bostick Womble | Nurse Practitioner | 512 Levee Street, Box 310, Rosedale, MS 38769-0310 | 2011-03-31 |
| 1043223340 | Rosedale Family Medical Center, P.C. | Family Medicine | 512 Levee St., Rosedale, MS 38769-0310 | 2006-08-15 |
| 1073536132 | John William Lewis Jr. | Family Medicine | 512 Levee Street, Rosedale, MS 38769-0310 | 2006-07-26 |
| 1003986993 | West Bolivar Elementary | Public Health or Welfare | 1212 South Main Street, Rosedale, MS 38769-0429 | 2006-11-08 |
| 1407991557 | Lewis Drug Store LLC | Pharmacy | 302 Court St, Rosedale, MS 38769-5509 | 2007-02-20 |
| Find all providers in zip 38769 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
| 1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
| 1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
| 1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
| 1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
| 1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
| 1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.