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Deactivated NPI 1124499637 Deactivated / Inactive NPI Male Practitioner

William Bolen

Specialist/Technologist • Ontario, OR

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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, William Bolen has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 09, 2015
NPI Deactivation Date September 23, 2019
Total Practice Duration ~4 Years of Practice (2015 – 2019)

Professional Overview & Biography Verified Profile Summary

William Bolen was a registered Specialist/Technologist practicing in Ontario, OR. Throughout an active medical career spanning 4 years, William Bolen provided care at the practice location at 1997 SW 4TH AVE until profile deactivation on 2019-09-23.

Practice Location & Contact Primary Location

Practice Address

1997 Sw 4th Ave

Ontario, OR 979141944

Telephone 5418896513
Associated Practice Facility / Clinic
🏢 Audio Hearing Aid Center Facility NPI 1912377318

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist/Technologist in Ontario, OR

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

Practicing in Ontario, OR (4 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

Specialist/Technologist Primary Specialty

NUCC Taxonomy Code: 235500000X

State License OR HAS-P-276799

General classification identifying individuals who are trained on a specific piece of equipment or technical procedure.

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 September 23, 2019

Record deactivated on September 23, 2019

NPI Profile Active October 09, 2015

NPI status registered as active in NPPES database

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Updated Practice Location October 09, 2015

Registered at 1997 SW 4TH AVE, ONTARIO, OR 979141944 (Tel: 5418896513)

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Updated Business Mailing Address October 09, 2015

Registered at 1997 SW 4TH AVE, ONTARIO, OR 979141944 (Tel: 5418896513)

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Provider Name / Credentials Updated October 09, 2015

Recorded as WILLIAM BOLEN

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 09, 2015

Specialist/Technologist (License #HAS-P-276799 in OR)

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Initial NPI Registration & Enumeration October 09, 2015

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: 1124499637
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 09, 2015
Last Update: October 09, 2015
Deactivation Date: September 23, 2019

Mailing Address

1997 Sw 4th Ave

Ontario, OR 979141944

Phone: 5418896513

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.