Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1740389543 Deactivated / Inactive NPI Male Practitioner

Dr. Jose M Bolanos , MD PA

Physician Assistant • Mt Vernon, AL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jose Bolanos has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 21, 2006
NPI Deactivation Date August 06, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Jose Bolanos, MD PA was a registered Physician Assistant practicing in Mt Vernon, AL. Throughout an active medical career spanning 15 years, Dr. Bolanos provided care at the practice location at 725 E COY SMITH HIGHWAY until profile deactivation on 2021-08-06.

Practice Location & Contact Primary Location

Practice Address

725 E Coy Smith Highway

Mt Vernon, AL 36560

Telephone 2516626700
Fax 2518295385
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Mt Vernon, AL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.6 Yrs
Regional Practice Density
1 Specialists

Practicing in Mt Vernon, AL (1153 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License AL PA64

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

19 Associated Practitioners
Amee Kozlovski

Psychiatry & Neurology - Psychiatry

NPI 1013243773
Dr. Damon Robinson , PhD

Psychologist - Clinical

NPI 1124211255

Doctor of Philosophy (Ph.D.)

Wendye Wofford , LCSW

Social Worker - Clinical

NPI 1295898484

Licensed Clinical Social Worker

Dr. Susan Rhodes , PhD

Psychologist - Clinical

NPI 1447326087

Doctor of Philosophy (Ph.D.)

Dr. Shelby Bruton , MD

Psychiatry & Neurology - Psychiatry

NPI 1467538959

Doctor of Medicine (M.D.)

Judy Laxton , LCSW PIP

Social Worker - Clinical

NPI 1487708335

LCSWPIP

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 06, 2021

Record deactivated on August 06, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 725 E COY SMITH HIGHWAY, MT VERNON, AL 36560 (Tel: 2516626700)

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Updated Business Mailing Address July 08, 2007

Registered at 725 E COY SMITH HIGHWAY, MT VERNON, AL 36560 (Tel: 2516626700)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JOSE BOLANOS, MD PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #PA64 in AL)

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Initial NPI Registration & Enumeration September 21, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1740389543
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 21, 2006
Last Update: July 08, 2007
Deactivation Date: August 06, 2021

Mailing Address

725 E Coy Smith Highway

Mt Vernon, AL 36560

Phone: 2516626700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.