MATTHEW DANE BOLTON (NPI# 1891163598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891163598 |
| Entity Type | Individual |
| Full Name | MATTHEW DANE BOLTON |
| Credential | CNP |
| Practice Address |
511 W Laurel Ave Hattiesburg MS 39401-3504 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6015441261 |
| Practice Fax Number | 6015839993 |
| Mailing Telephone | 6015441261 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2016-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R885021 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00880352 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720082548 | Matthew Bolton | Family Medicine | 1503 S Main St, Crossville, TN 38555-5967 | 2005-06-09 |
| 1548794746 | Matthew Bolton | Occupational Therapist | 140 Washington Ave, Hamden, CT 06518-3012 | 2017-04-13 |
| 1992199129 | Matthew Bolton | Ophthalmology | 1430 Tulane Ave, Sl-50, New Orleans, LA 70112-2632 | 2015-03-25 |
| Street Address |
511 W LAUREL AVE |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401-3504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942213103 | Charles D Hernandez | Internal Medicine | 511 W Laurel Ave, Hattiesburg, MS 39401-3504 | 2006-08-15 |
| 1336416973 | Downtown Pharmacy | Pharmacy | 511 W Laurel Ave, Hattiesburg, MS 39401-3504 | 2011-11-28 |
| 1386733350 | Hattiesburg Clinic Pa | Internal Medicine | 511 W Laurel Ave, Hattiesburg, MS 39401-3504 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427517770 | Tiffanie Suzanne Bellino | Nurse Practitioner | 751 Harold Tucker Rd, Hattiesburg, MS 39401-9529 | 2019-03-17 |
| 1790284222 | Gaynell Galt Martin | Nurse Practitioner | 1 Lincoln Pkwy Ste 106, Hattiesburg, MS 39402-3261 | 2018-02-10 |
| 1831597202 | Markus Dick Craig | Nurse Practitioner | 82 Serene Hills, Hattiesburg, MS 39402 | 2014-12-16 |
| 1104243195 | Marcie Lee | Nurse Practitioner | 51 Brooks Rd, Hattiesburg, MS 39401-8927 | 2014-03-27 |
| 1013258524 | Planned Parenthood Southeast, Inc. | Nurse Practitioner | 214 S 27th Ave, Hattiesburg, MS 39401-7165 | 2013-03-07 |
| 1699064659 | John E. Marsh | Nurse Practitioner | 1 Lincoln Pkwy Ste 103, Hattiesburg, MS 39402-3261 | 2011-03-30 |
| 1598947590 | Deborah T Anderson | Nurse Practitioner | 6101 U S Highway 49, Hattiesburg, MS 39401-7158 | 2007-11-30 |
| 1962628966 | Traci Davis Suber | Nurse Practitioner | 421 S 28th Ave Ste 200, Hattiesburg, MS 39401-7208 | 2007-04-18 |
| 1649380940 | Billy R Windham | Nurse Practitioner | 103 Tatum Park, Hattiesburg, MS 39401 | 2006-08-30 |
| 1528177540 | Neelou M. Patel | Nurse Practitioner | 34 Millbranch Rd Ste 80, Hattiesburg, MS 39402 | 2006-08-30 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
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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.