DR. WILLIAM TODD BOLEMAN (NPI# 1558320119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558320119 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM TODD BOLEMAN |
| Credential | MD |
| Practice Address |
690 Dallas Hwy Suite 101 Villa Rica GA 30180-1264 |
| Practice Telephone | 7704590620 |
| Practice Fax Number | 7704567604 |
| Mailing Telephone | 7704590620 |
| Mailing Fax Number | 7704567604 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2012-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 068372 | GA | Allopathic & Osteopathic Physicians |
| N | 207K00000X | Allergy & Immunology | MD-050257-L | PA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MD-050257-L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | PENDING | 05 |
| Street Address |
690 DALLAS HWY SUITE 101 |
| City | VILLA RICA |
| State | GA |
| Zip Code | 30180-1264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538161492 | Bonnie Kristine Boles | Internal Medicine | 690 Dallas Hwy, Suite 207-a, Villa Rica, GA 30180-1264 | 2005-08-11 |
| 1366797391 | Julie Inez Burke | Clinical Nurse Specialist | 690 Dallas Hwy, Suite 201, Villa Rica, GA 30180-1264 | 2012-07-16 |
| 1104113919 | Kaysi Benefield | Obstetrics & Gynecology | 690 Dallas Hwy, Suite 301, Villa Rica, GA 30180-1264 | 2011-06-30 |
| 1972824712 | Tiffany L Stanfill | Obstetrics & Gynecology | 690 Dallas Hwy, Suite 301, Villa Rica, GA 30180-1264 | 2010-06-16 |
| 1497982656 | Linda R Mcdaniel | Advanced Practice Midwife | 690 Dallas Hwy, Suite 301, Villa Rica, GA 30180-1264 | 2009-06-16 |
| 1346406071 | Tmc Internal Medicine of Villa Rica, Inc. | Internal Medicine | 690 Dallas Hwy, Suite 301, Villa Rica, GA 30180-1264 | 2008-08-01 |
| 1073710646 | Amanda Kauffmann Nguyen | Pediatrics | 690 Dallas Hwy, Suite 206, Villa Rica, GA 30180-1264 | 2007-06-28 |
| 1669677498 | Robin Renee Childress-rodriguez | Nurse Practitioner | 690 Dallas Hwy, Ste 101, Villa Rica, GA 30180-1264 | 2007-06-20 |
| 1982724811 | Virginia Singer | Nurse Practitioner | 690 Dallas Hwy, Suite 201, Villa Rica, GA 30180-1264 | 2007-04-02 |
| 1477615862 | Carlos Julio Moreno | Physician Assistant | 690 Dallas Hwy, Suite 101, Villa Rica, GA 30180-1264 | 2006-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174161624 | Crucible Communication Therapy LLC | Speech-Language Pathologist | 9765 Walnut Grove Trail, Villa Rica, GA 30180 | 2019-12-16 |
| 1366802845 | Medic-pearl, LLC | Ambulance | 1108 Charter Oak Ct, Villa Rica, GA 30180 | 2016-02-26 |
| 1396138368 | Josette Etienne | Nurse Practitioner | 403 Permian Way Suite A, Villa Rica, GA 30180 | 2015-03-13 |
| 1447690516 | Judith L.m. Thigpen | Nurse Practitioner | 736 Highway 78 West, Minute Clinic, Villa Rica, GA 30180 | 2013-07-03 |
| 1477890168 | Wesley Douglas Mckenzie | Pharmacist | 2500 Mirror Lake Blvd, Villa Rica, GA 30180 | 2013-01-15 |
| 1497005359 | Malika Remie Rajendra | Optometrist | 600 Hwy 61, Villa Rica, GA 30180 | 2012-09-18 |
| 1972876449 | Catherine Elaine Tyson | Pharmacist | 601 Dallas Road, Villa Rica, GA 30180 | 2012-02-14 |
| 1619262433 | Villa Rica Rx LLC | Pharmacy | 222 West Wilson Street, Villa Rica, GA 30180 | 2011-06-09 |
| 1851602874 | Jules Chopin Sybert | Nurse Practitioner | 736 W. Bankhead Hwy, Villa Rica, GA 30180 | 2010-06-24 |
| 1487984019 | Lisa Wood | Occupational Therapy Assistant | 1207 Woods Walk, Villa Rica, GA 30180 | 2010-01-04 |
| Find all providers in zip 30180 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568563914 | Eugene Stanley Hurwitz | Allergy & Immunology | 690 Dallas Hwy, Suite 101, Villa Rica, GA 30180-1209 | 2006-09-26 |
| 1578504536 | Center for Allergy & Asthma of Georgia PC | Allergy & Immunology | 690 Dallas Hwy, Suite 101, Villa Rica, GA 30180 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935411 | St. Mary's Medical Group, Inc. | Allergy & Immunology | 1360 Caduceus Way Bldg 200-102, Watkinsville, GA 30677-7349 | 2020-06-02 |
| 1750902185 | Center for Allergy and Asthma Southern Crescent | Allergy & Immunology | 1975 Highway 54 W Ste 255, Peachtree City, GA 30269-4794 | 2020-04-27 |
| 1003472036 | Annual Wellness Centers of America | Allergy & Immunology | 753 Old Norcross Rd Ste B, Lawrenceville, GA 30046-4312 | 2019-05-15 |
| 1821567371 | Breathe Better Allergy Asthma & Sinus Center, Inc | Allergy & Immunology | 950 S Enota Dr Ne Ste A, Gainesville, GA 30501-2439 | 2018-11-14 |
| 1982111316 | Sofia Miriam Sheikh | Allergy & Immunology | 4003 Oak Forest Dr Ne, Marietta, GA 30062-8022 | 2018-01-08 |
| 1366969560 | Allergy Consulting Group, LLC | Allergy & Immunology | 5752b Buford Hwy Ne, Doraville, GA 30340-1207 | 2017-08-28 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1730597196 | Allergy Testing Solutions, LLC | Allergy & Immunology | 789 Hammond Dr, Unit 2510, Sandy Springs, GA 30328-8161 | 2014-07-30 |
| 1164863999 | Chih-yin Yeh | Allergy & Immunology | 5673 Peachtree Dunwoody Rd # 445, Atlanta, GA 30342-1731 | 2013-07-09 |
| 1023352069 | Advanced Allergy Inc | Allergy & Immunology | 5512 Glenridge Dr Ne, Unit A, Atlanta, GA 30342-7213 | 2012-11-15 |
| Find all providers with the same taxonomy | ||||
| City | VILLA RICA |
| Zip Code | 30180 |
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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.