Michael Joseph Boland (NPI# 1104867936, PAC ID# 4284602905) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIOVASCULAR DISEASE (CARDIOLOGY).
| Nation Provider ID (NPI) | 1104867936 |
| PAC ID by PECOS | 4284602905 |
| Professional Enrollment ID | I20040921000576 |
| Full Name | Michael Joseph Boland |
| Organization Legal Name | NORTH MISSISSIPPI GILMORE CLINICS LLC |
| Address |
404 Gilmore Dr Amory MS 38821-5414 |
| Phone Number | 6622563564 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1972 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 2961745195 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250025 | GILMORE MEMORIAL HOSPITAL |
| 250004 | NORTH MISSISSIPPI MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 404 Gilmore Dr, Amory, MS 38821-5414 | 6622563564 | NORTH MISSISSIPPI GILMORE CLINICS LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_047_overall | Care Plan | 39% | |
| MIPS_EC_047_overall | Care Plan | 39% |
| Organization Legal Name | NORTH MISSISSIPPI GILMORE CLINICS LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew J Harris | Nurse Practitioner | North Mississippi Gilmore Clinics LLC | 40023 Cross Creek Dr, Hamilton, MS 39746-8801 |
| William Mc Comb | Internal Medicine | North Mississippi Gilmore Clinics LLC | 1107 Earl Frye Blvd, Suite 6 Amory Specialty Clinic, Amory, MS 38821-5519 |
| Teresa Stanford | Nurse Practitioner | North Mississippi Gilmore Clinics LLC | 404 Gilmore Dr, Amory, MS 38821-5414 |
| Benjamin Thomas Boatright | Gastroenterology | North Mississippi Gilmore Clinics LLC | 1107 Earl Frye Blvd, Suite 5 Amory Children's Clinic, Amory, MS 38821-5519 |
| Sharla E Saylors | Nurse Practitioner | North Mississippi Gilmore Clinics LLC | 404 Gilmore Dr, Amory, MS 38821-5414 |
| James W Lewis | Pathology | North Mississippi Gilmore Clinics LLC | 1105 Earl Frye Blvd, Amory Pathology, Amory, MS 38821-5500 |
| Brenda Elain Worthey | Nurse Practitioner | North Mississippi Gilmore Clinics LLC | 1107 Earl Frye Blvd, Suite 5 Amory Children's Clinic, Amory, MS 38821-5519 |
| Timothy B Watson | Nurse Practitioner | North Mississippi Gilmore Clinics LLC | 1107 Earl Frye Blvd, Suite 6 Amory Specialty Clinic, Amory, MS 38821-5519 |
| Street Address |
404 GILMORE DR |
| City | AMORY |
| State | MS |
| Zip | 38821-5414 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Teresa Stanford | Nurse Practitioner | North Mississippi Gilmore Clinics LLC | 404 Gilmore Dr, Amory, MS 38821-5414 |
| Sharla E Saylors | Nurse Practitioner | North Mississippi Gilmore Clinics LLC | 404 Gilmore Dr, Amory, MS 38821-5414 |
| Gerald L Parker | Family Practice | Amory Regional Physicians LLC | 404 Gilmore Dr, Amory, MS 38821-5414 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gail Miller | Certified Registered Nurse Anesthetist (crna) | Willow Anesthesia Services, LLC | 1105 E Fry Blvd, Amory, MS 38821-3227 |
| James A Mcdaniel | Certified Registered Nurse Anesthetist (crna) | Willow Anesthesia Services, LLC | 1105 E Fry Blvd, Amory, MS 38821-3227 |
| Juli K Johnson | Certified Registered Nurse Anesthetist (crna) | Willow Anesthesia Services, LLC | 1105 Earl Frye Blvd, Gilmore Regional Medical Center, Amory, MS 38821-3227 |
| Tara Wadkins | Certified Registered Nurse Anesthetist (crna) | Willow Anesthesia Services, LLC | 1105 E Fry Blvd, Amory, MS 38821-3227 |
| Sarah E Hodge | Certified Registered Nurse Anesthetist (crna) | Willow Anesthesia Services, LLC | 1105 E Fry Blvd, Amory, MS 38821-3227 |
| Cheryl Burcham | Certified Registered Nurse Anesthetist (crna) | Willow Anesthesia Services, LLC | 1105 Earl Frye Blvd, Gilmore Regional Medical Center, Amory, MS 38821-3227 |
| Angela Serio | Certified Registered Nurse Anesthetist (crna) | Willow Anesthesia Services, LLC | 1105 Earl Frye Blvd, Gilmore Regional Medical Center, Amory, MS 38821-3227 |
| Lewis Richard French | Chiropractic | 200 3rd St N, Amory, MS 38821-3423 | |
| Steve Randle | Optometry | 307 Main S St, Amory, MS 38821-4219 | |
| Robert C Kirksey | Emergency Medicine | Mississippi Emergency Physician Services LLC | 1105 Earl Frye Blvd, Gilmore Memorial Regional Medical Ctr, Amory, MS 38821-5500 |
| Find all physicians in zip 38821 | |||
| City | AMORY |
| Zip Code | 38821 |
| Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| City + Specialty | AMORY + CARDIOVASCULAR DISEASE (CARDIOLOGY) |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.