BOLICK CLINIC, INC.
NPI 1073680088
Clinic/Center - Multi-Specialty in Maitland, FL
About Bolick Clinic, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BOLICK CLINIC, INC. (NPI 1073680088) is a healthcare organization registered as a multi-specialty in Maitland, Florida and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists Channing C Bolick, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Other Identifiers 2
Group Practice 1
Accepted 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)
Bolick Clinic, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Bolick Clinic, Inc., which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D0273769
Bolick Clinic The · Maitland, FLFrequently 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 Bolick Clinic, Inc.'s NPI number?
The NPI number for Bolick Clinic, Inc. is 1073680088. It was assigned to this organization in the NPPES registry on November 29, 2006. The provider is also known as The Bolick Clinic.
Where is Bolick Clinic, Inc. located?
Bolick Clinic, Inc. is located at 500 E Horatio Ave Ste 5, Maitland, FL 32751. The listed phone number is (407) 629-5333.
What is Bolick Clinic, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Bolick Clinic, Inc. enrolled in Medicare?
Yes. Bolick Clinic, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bolick Clinic, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Bolick Clinic, Inc.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Bolick Clinic, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D0273769) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Bolick Clinic, Inc. accept?
Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Bolick Clinic, Inc. 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 Bolick Clinic, Inc. was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Bolick Clinic, Inc. · NPI 1073680088
Multi-Specialty organization in Maitland, Florida. Organization record, active in the CMS NPPES registry since November 29, 2006.
## Identity
- **NPI:** 1073680088 (Entity type: Organization)
- **Enumerated:** November 29, 2006
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Also known as:** The Bolick Clinic (Other Name)
- **Organization subpart:** No
- **Authorized official:** Channing Bolick, PRESIDENT
## Practice location
- **Address:** 500 E HORATIO AVE STE 5, Maitland, FL 32751-7310
- **Phone:** (407) 629-5333 · **Fax:** (407) 629-5343
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 23, 2025
- **Other identifiers:** Medicaid 3819132-00 (FL); Other 55996 (FL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1073680088) · Data from the CMS NPPES public registry.