BOLIVAR GENERAL HOSPITAL, INC. (NPI# 1689665754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689665754 |
| Entity Type | Organization |
| Organization Name | BOLIVAR GENERAL HOSPITAL, INC. |
| Other Organization Name | WEST TENNESSEE HEALTHCARE BOLIVAR HOSPITAL |
| Practice Address |
650 Nuckolls Rd Bolivar TN 38008-1532 |
| Practice Telephone | 7316583100 |
| Practice Fax Number | 7316590259 |
| Mailing Telephone | 7316583100 |
| Mailing Fax Number | 7316590259 |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2020-07-24 |
| Authorized Official Name | MR. JAMES ROSS (INTERIM PRESIDENT AND CEO) |
| Authorized Official Telephone | 7315415000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | 0000000062 | TN | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 044U181 | 05 |
| Other Name | Type Code |
|---|---|
| West Tennessee Healthcare Bolivar Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518957950 | Bolivar General Hospital, Inc. | Medicare Defined Swing Bed Unit | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2005-10-26 |
| 1538634050 | Bolivar General Hospital, Inc. | Family Medicine | 640 Nuckolls Rd, Bolivar, TN 38008-1532 | 2018-10-11 |
| 1174545446 | Bolivar General Hospital, Inc. | General Acute Care Hospital | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2006-07-24 |
| Street Address |
650 NUCKOLLS RD |
| City | BOLIVAR |
| State | TN |
| Zip Code | 38008-1532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518957950 | Bolivar General Hospital, Inc. | Medicare Defined Swing Bed Unit | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2005-10-26 |
| 1659713386 | Top Flight Medical Group | Specialist | 650 Nuckolls Rd, Specialty Clinic, Bolivar, TN 38008-1532 | 2013-07-23 |
| 1003181819 | Nathan Strickland | Dietitian, Registered | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2012-03-12 |
| 1205979002 | Bolivar General Hospital Pharmacy | Pharmacy | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2007-02-14 |
| 1174545446 | Bolivar General Hospital, Inc. | General Acute Care Hospital | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2006-07-24 |
| 1689608853 | Jackson Madison County General Hospital | General Acute Care Hospital | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2006-07-11 |
| 1760412654 | George Spanos | Emergency Medicine | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2006-07-04 |
| 1770521940 | William Raymond Carney | Emergency Medicine | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720639172 | Shanna Shackelford | Nurse Practitioner | 11100 Old Hwy 64 W, Bolivar, TN 38008 | 2019-09-26 |
| 1598326233 | Holly Brooke Shourd | Family Medicine | 1359 W Market St., Bolivar, TN 38008 | 2019-06-24 |
| 1992299234 | Angela Dawn Haynes | Registered Nurse | 10825 Hwy 64w, Bolivar, TN 38008 | 2018-06-20 |
| 1326595919 | Ashley Evon Jowers | Nurse Practitioner | 11100 Old Hwy 64 West, Bolivar, TN 38008 | 2016-09-01 |
| 1942458344 | Anita Pearl Johnson | Physical Therapy Assistant | 700 Knuckolls Ave, Bolivar, TN 38008 | 2008-08-28 |
| 1841340007 | State of Tennessee | Public Health or Welfare | 10825 Old Hwy 64, Bolivar, TN 38008 | 2007-01-11 |
| 1164479721 | Betty Ragon Lenoir | Physical Therapist | 789 Tennessee St, Bolivar, TN 38008 | 2006-05-28 |
| 1689623050 | County of Hardeman | Ambulance | 735 Naylor St, Bolivar, TN 38008 | 2006-05-10 |
| 1841287109 | Michiel Brent Rudder | Family Medicine | 622 West Market Street, Bolivar, TN 38008 | 2005-10-03 |
| 1982606497 | Richard Mast Reinhard IIi | Pediatrics | 629 Nuckolls Rd, Bolivar, TN 38008 | 2005-08-15 |
| Find all providers in zip 38008 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518957950 | Bolivar General Hospital, Inc. | Medicare Defined Swing Bed Unit | 650 Nuckolls Rd, Bolivar, TN 38008-1532 | 2005-10-26 |
| 1841328424 | Citizens Memorial Hospital District | Medicare Defined Swing Bed Unit | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2007-03-02 |
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|---|---|---|---|---|
| 1134655731 | West Tennessee Rehabilitation Hospital, LLC | Medicare Defined Swing Bed Unit | 180 Mount Pelia Road, Martin, TN 38237 | 2017-05-03 |
| 1073622007 | Chattanooga Hamilton County Hospital Authority | Medicare Defined Swing Bed Unit | 71 Wheelertown Avenue, Pikeville, TN 37367 | 2006-08-30 |
| 1598734352 | Rebound LLC | Medicare Defined Swing Bed Unit | 190 Mount Pelia Rd, Martin, TN 38237-3812 | 2006-03-15 |
| 1821060930 | Martin Health | Medicare Defined Swing Bed Unit | 161 Mount Pelia Rd, Martin, TN 38237-3811 | 2006-02-02 |
| 1952900920 | Vanderbilt Bedford Hospital, LLC | Medicare Defined Swing Bed Unit | 2835 Highway 231 N, Shelbyville, TN 37160-7327 | 2020-10-21 |
| 1750904041 | Tullahoma Hma LLC | Medicare Defined Swing Bed Unit | 1801 N Jackson St, Tullahoma, TN 37388-8259 | 2020-05-21 |
| 1427671718 | Clarksville Health System Gp | Medicare Defined Swing Bed Unit | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2020-05-21 |
| 1518580893 | Cleveland Tennessee Hospital Company LLC | Medicare Defined Swing Bed Unit | 2305 Chambliss Ave Nw, Cleveland, TN 37311-3847 | 2020-05-21 |
| 1417570961 | Metro Knoxville Hma LLC | Medicare Defined Swing Bed Unit | 7565 Dannaher Dr, Powell, TN 37849-4029 | 2020-05-19 |
| 1356973663 | Lauderdale Community Hospital LLC | Medicare Defined Swing Bed Unit | 326 Asbury Ave, Ripley, TN 38063-5577 | 2020-02-05 |
| 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.