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BOLIVAR PHYSICIAN PRACTICES LLC
NPI 1043454655
Family Medicine in Cleveland, MS

Active since April 27, 2009
810 E SUNFLOWER RD, STE. 100A, CLEVELAND, MS 38732(662) 843-8885(662) 843-2280 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 4, 2026, Jun 3, 2024 (2 updates tracked since 2024).

About Bolivar Physician Practices Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOLIVAR PHYSICIAN PRACTICES LLC (NPI 1043454655) is a healthcare organization registered as a family medicine in Cleveland, Mississippi and active in the NPI registry since April 2009. The organization lists Charlotte Lawrence, Secretary, as its authorized official.

NPPES Registry Identity

NPI1043454655
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBOLIVAR PHYSICIAN PRACTICES LLC
Location Address810 E SUNFLOWER RD, STE. 100ACleveland, MS 38732-2800
Mailing Address810 E Sunflower Rd Ste 100aCleveland, MS 38732-2828
Phone(662) 843-8885
Fax(662) 843-2280
Organization SubpartNo
Authorized OfficialCharlotte LawrenceSecretary · (615) 920-7000
Enumeration DateApril 27, 2009
Last NPPES UpdateJune 4, 20262 updates tracked since enumeration
NPPES CertifiedJune 4, 2026
✔ NPI 1043454655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedOtolaryngologyTaxonomy 207Y00000X
Also ListedUrologyTaxonomy 208800000X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
810 E SUNFLOWER RD, Cleveland, MS 38732
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bolivar Physician Practices Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

42

Medicare enrollment records show 42 clinicians reassign Medicare billing to Bolivar Physician Practices LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 19 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 8

Nurse Practitioner15
Obstetrics/Gynecology7
General Surgery6
Family Practice5
Internal Medicine4
Orthopedic Surgery3
Thoracic Surgery1
Urology1

Nearest to this location (20)

See all 42
Jacquanne Barnes, NP
Nurse Practitioner
NPI 1972562114
810 E SUNFLOWER RD SUITE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts MedicareSame address
David Walt, MD
Internal Medicine
NPI 1205895448
810 E SUNFLOWER RD SUITE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOSSame address
Paul Warrington, MD
Family Practice
NPI 1831168350
810 E SUNFLOWER RD SUITE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOSSame address
John Carr, MD
Thoracic Surgery
NPI 1457353658
810 E SUNFLOWER RD STE 100A
Cleveland, MS 38732
(662) 579-0118
✔ PECOS✔ Accepts Medicare0.1 mi
Matthew Bear, DO
Internal Medicine
NPI 1023646403
810 EAST SUNFLOWER RD SUITE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare0.1 mi
Angela Parish, CFNP
Nurse Practitioner
NPI 1144241910
810 E SUNFLOWER RD STE 100E
Cleveland, MS 38732
(662) 846-6034
✔ PECOS0.1 mi
Zachary Watters
Internal Medicine
NPI 1871243261
810 E SUNFLOWER RD
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare0.1 mi
Stephanie Hodnett
Nurse Practitioner
NPI 1679028377
801 1ST ST
Cleveland, MS 38732
(985) 892-7070
✔ PECOS✔ Accepts Medicare0.1 mi
Bradley Baugh, MD
Obstetrics/Gynecology
NPI 1285728626
801 FIRST ST
Cleveland, MS 38732
(662) 843-0880
✔ PECOS✔ Accepts Medicare0.1 mi
Mark Blackwood, MD
Obstetrics/Gynecology
NPI 1558456764
801 FIRST ST
Cleveland, MS 38732
(662) 843-0880
✔ PECOS✔ Accepts Medicare0.1 mi
Degail Hadley, D.O.
Family Practice
NPI 1720216955
700 E SUNFLOWER RD
Cleveland, MS 38732
(662) 441-2309
✔ PECOS✔ Accepts Medicare1.2 mi
Maghan Ashmore, FNP-BC
Nurse Practitioner
NPI 1720624430
810 E SUNFLOWER RD STE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare1.2 mi
Charles Brock, M.D.
Family Practice
NPI 1689761280
810 E SUNFLOWER RD
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare1.2 mi
Steven Clark, M.D
Internal Medicine
NPI 1053408476
810 E SUNFLOWER RD
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare1.2 mi
Keila Mayfield, FNP
Nurse Practitioner
NPI 1235709494
810 E. SUNFLOWER ROAD SUITE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare1.2 mi
Clare Moore, FNP
Nurse Practitioner
NPI 1104332089
810 E SUNFLOWER RD
Cleveland, MS 38732
(662) 579-0136
✔ PECOS✔ Accepts Medicare1.2 mi
Brooke Tims, RN, CFNP
Nurse Practitioner
NPI 1477575561
810 E SUNFLOWER RD STE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare1.2 mi
Bennie Wright, M.D.
General Surgery
NPI 1992857106
810 E SUNFLOWER RD SUITE 100A
Cleveland, MS 38732
(662) 846-6015
✔ PECOS✔ Accepts Medicare1.2 mi
Derek Miles, MD
Urology
NPI 1407887391
907 E SUNFLOWER RD SUITE 103
Cleveland, MS 38732
(662) 846-9990
✔ PECOS✔ Accepts Medicare1.3 mi
Brooke Scallion, FNP-C
Nurse Practitioner
NPI 1609385392
125 N MAIN ST
Drew, MS 38737
(662) 649-6045
✔ PECOS✔ Accepts Medicare11 mi
See all 42 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bolivar Physician Practices LLC's NPI number?

The NPI number for Bolivar Physician Practices LLC is 1043454655. It was assigned to this organization in the NPPES registry on April 27, 2009.

Where is Bolivar Physician Practices LLC located?

Bolivar Physician Practices LLC is located at 810 E Sunflower Rd Ste. 100A, Cleveland, MS 38732. The listed phone number is (662) 843-8885.

What is Bolivar Physician Practices LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Bolivar Physician Practices LLC enrolled in Medicare?

Yes. Bolivar Physician Practices LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bolivar Physician Practices LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 42 clinicians in 8 Medicare specialties reassign their Medicare billing to Bolivar Physician Practices LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (15), Obstetrics/Gynecology (7) and General Surgery (6). Of these, 3 practice at this address and 19 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Bolivar Physician Practices LLC accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Bolivar Physician Practices LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bolivar Physician Practices LLC was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.