ELISSA ANN BOLLING (NPI# 1871038265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871038265 |
| Entity Type | Individual |
| Full Name | ELISSA ANN BOLLING |
| Credential | P.A. |
| Practice Address |
13640 Steelecroft Pkwy Charlotte NC 28278-7565 |
| Mailing Address |
608 Marsh Rd Charlotte NC 28209-1849 |
| Practice Telephone | 7045125500 |
| Mailing Telephone | 3364144041 |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2017-02-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-06990 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
13640 STEELECROFT PKWY |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28278-7565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063444263 | Charles Bale | Obstetrics & Gynecology | 13640 Steelecroft Pkwy, Ste 240, Charlotte, NC 28278-7565 | 2006-07-07 |
| 1740711076 | John Licata | Pediatrics | 13640 Steelecroft Pkwy, Ste 210, Charlotte, NC 28278-7565 | 2017-03-27 |
| 1518339902 | Dustin Huerta | Nurse Practitioner | 13640 Steelecroft Pkwy, Charlotte, NC 28278-7565 | 2015-10-23 |
| 1497131031 | Kanitra Clyburn | Nurse Practitioner | 13640 Steelecroft Pkwy, Ste 210, Charlotte, NC 28278-7565 | 2015-08-05 |
| 1316328818 | Shirin Jafari-namin | Pediatrics | 13640 Steelecroft Pkwy, Ste 210, Charlotte, NC 28278-7565 | 2015-06-11 |
| 1366847915 | Sana Umair | Hospitalist | 13640 Steelecroft Pkwy, Ste 320, Charlotte, NC 28278-7565 | 2014-10-24 |
| 1972924157 | Kathryn Alexis Repas | Physician Assistant | 13640 Steelecroft Pkwy, Charlotte, NC 28278-7565 | 2013-12-14 |
| 1023455425 | Colleen Pettrey | Internal Medicine | 13640 Steelecroft Pkwy, Ste 320, Charlotte, NC 28278-7565 | 2013-05-28 |
| 1801233390 | Courtney Moynihan | Obstetrics & Gynecology | 13640 Steelecroft Pkwy, Ste 240, Charlotte, NC 28278-7565 | 2013-05-24 |
| 1407299415 | Mitchell Alvarez | Obstetrics & Gynecology | 13640 Steelecroft Pkwy, Ste 240, Charlotte, NC 28278-7565 | 2013-04-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366060170 | Stride | Community/Behavioral Health | 14054 Singleleaf Lane, Charlotte, NC 28278 | 2020-07-08 |
| 1245742279 | Ruby Home Healthcare, LLC | Home Health | 17202 Belmont Stakes Lane, Charlotte, NC 28278 | 2017-10-31 |
| 1962926287 | Limitless Little Learners | Community/Behavioral Health | 13909 Derby Farm Lane, Charlotte, NC 28278 | 2017-07-28 |
| 1497106694 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 4821 Berewick Town Center Dr, Charlotte, NC 28278 | 2016-06-29 |
| 1932574753 | Adrienne Forney | Counselor | 14923 Alyssa Faith Court, Charlotte, NC 28278 | 2015-12-04 |
| 1447620398 | Sherae Threatt Lattimore | Behavioral Analyst | 5614 Samuel Neel Rd, Charlotte, NC 28278 | 2015-10-05 |
| 1528340676 | Khyati Dhaval Shah | Pediatrics | 13557 Steelecroft Pkwy Ste 2200, Charlotte, NC 28278 | 2011-09-14 |
| 1184915043 | John Angelo Tenini | Internal Medicine | 13557 Steelecroft Pkwy Ste 1200, Charlotte, NC 28278 | 2011-04-27 |
| 1568612240 | Kim Marie Briden | Contractor | 13805 Appling Lane, Charlotte, NC 28278 | 2008-09-30 |
| 1144477258 | Presbyterian Imaging Centers LLC | Radiology | 13557 Steelecroft Parkway, Suite 1100, Charlotte, NC 28278 | 2008-08-20 |
| Find all providers in zip 28278 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351607 | Michael James Blackwell | Physician Assistant | 501 Billingsley Rd Ste B, Charlotte, NC 28211-1009 | 2020-09-22 |
| 1598371320 | Jonathan Byron Lively | Physician Assistant | 1000 Blythe Blvd Fl 3, Charlotte, NC 28203-5812 | 2020-09-17 |
| 1902415532 | Jacqueline Ellen Leyrer | Physician Assistant | 2630 E 7th St Ste 200, Charlotte, NC 28204-4319 | 2020-07-29 |
| 1750908380 | Whitney Debroy | Physician Assistant | 125 W Tremont Ave Unit 726, Charlotte, NC 28203-5551 | 2020-06-30 |
| 1972129302 | Ashley Nicole Short | Physician Assistant | 1022 E Worthington Ave, Charlotte, NC 28203-5760 | 2020-06-22 |
| 1558985176 | Courtney Claugus | Physician Assistant | 300 E Park Ave Unit 7, Charlotte, NC 28203-4774 | 2020-05-29 |
| 1467071738 | Patrick James Quinn | Physician Assistant | 2036 Millerton Ave Apt 4311, Charlotte, NC 28208-5290 | 2020-04-15 |
| 1225660301 | Sunil Ranchhod Ghodasara | Physician Assistant | 1001 Blythe Blvd Ste 403, Charlotte, NC 28203-5863 | 2020-02-06 |
| 1225668601 | Emily Rebecca Markey | Physician Assistant | 355 W Mlk Blvd Apt 1112, Charlotte, NC 28202-0043 | 2020-01-24 |
| 1639719586 | Abosede Elizabeth Adamson | Physician Assistant | 3101 Amesbury Hill Dr, Charlotte, NC 28269-8951 | 2020-01-08 |
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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.