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Deactivated NPI 1407970445 Deactivated / Inactive NPI Male Practitioner

Michael D Bolling

Contractor - Home Modifications • Shawnee, OK

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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, Michael Bolling has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 16, 2007
NPI Deactivation Date June 10, 2019
Total Practice Duration ~12 Years of Practice (2007 – 2019)

Professional Overview & Biography Verified Profile Summary

Michael Bolling was a registered Contractor - Home Modifications practicing in Shawnee, OK. Throughout an active medical career spanning 12 years, Michael Bolling provided care at the practice location at 519 N BEARD ST until profile deactivation on 2019-06-10.

Practice Location & Contact Primary Location

Practice Address

519 N Beard St

Shawnee, OK 748016729

Telephone 4052737638
Fax 4052730037
Associated Practice Facility / Clinic
🏢 Eternal Kingdom Enterprises, Inc. Facility NPI 1851415855

Specialty Benchmarks & Practice Insights

Comparative analytics for Contractor - Home Modifications in Shawnee, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Shawnee, OK (8 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

Contractor - Home Modifications Primary Specialty

NUCC Taxonomy Code: 171WH0202X

Definition to come...

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 June 10, 2019

Record deactivated on June 10, 2019

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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 519 N BEARD ST, SHAWNEE, OK 748016729 (Tel: 4052737638)

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Updated Business Mailing Address July 08, 2007

Registered at 519 N BEARD ST, SHAWNEE, OK 748016729 (Tel: 4052737638)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MICHAEL BOLLING

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

Contractor

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Initial NPI Registration & Enumeration March 16, 2007

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: 1407970445
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 16, 2007
Last Update: July 08, 2007
Deactivation Date: June 10, 2019
Update or Correct Profile

Mailing Address

519 N Beard St

Shawnee, OK 748016729

Phone: 4052737638

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.