HALEY BOLEN CRNP
NPI 1104416486
Nurse Practitioner - Family in Northport, AL
About Haley Bolen Crnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HALEY BOLEN CRNP (NPI 1104416486) is an individual family provider in Northport, Alabama, licensed in Alabama (1-145272) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Haley Bolen Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Haley Bolen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Northport, AL 35476
- Reassigned Medicare billing, Alabama enrollment
- 118 clinicians in this Medicare group
Tuscaloosa, AL 35401
- Reassigned Medicare billing, Alabama enrollment
- 124 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 35475 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Haley Bolen's NPI number?
The NPI number for Haley Bolen is 1104416486. It was assigned to this individual provider in the NPPES registry on January 21, 2021.
Where is Haley Bolen located?
Haley Bolen practices at 1116 Mitt Lary Rd, Northport, AL 35475. The listed phone number is (205) 556-5634.
What is Haley Bolen's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Haley Bolen enrolled in Medicare?
Yes. Haley Bolen is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Haley Bolen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Haley Bolen reassigns Medicare benefits to 2 organizations: Relias Emergency Medicine Specialists Of Northport, LLC (Northport, AL) and Relias Emergency Medicine Specialists Of Regional, LLC (Tuscaloosa, AL). Each 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 Haley Bolen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Haley Bolen accept?
Health plans from Blue Cross and Blue Shield of Alabama list Haley Bolen 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 Haley Bolen was last updated on January 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Haley Bolen, CRNP · NPI 1104416486
Family physician in Northport, Alabama. Individual provider, active in the CMS NPPES registry since January 21, 2021.
## Identity
- **NPI:** 1104416486 (Entity type: Individual)
- **Enumerated:** January 21, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 1-145272 (Alabama)
- **Sole proprietor:** No
## Practice location
- **Address:** 1116 MITT LARY RD, Northport, AL 35475-4978
- **Phone:** (205) 556-5634
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Relias Emergency Medicine Specialists Of Northport, LLC (NPI 1699261149, Northport, AL); Relias Emergency Medicine Specialists Of Regional, LLC (NPI 1619463163, Tuscaloosa, AL) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 21, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1104416486) · Data from the CMS NPPES public registry.