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DR. JIMMY G BOZEMAN M.D.
NPI 1164499935
General Practice in Salem, AR

Active since March 01, 2006PECOS Enrolled
507 N MAIN ST, SALEM, AR 72576(870) 895-2541(870) 895-2957 Get Directions Write a Review

NPPES record last updated: February 1, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Jimmy G Bozeman M.d. NPPES

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

DR. JIMMY G BOZEMAN M.D. (NPI 1164499935) is an individual general practice provider in Salem, Arkansas, licensed in Arkansas (C-4579) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164499935
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. JIMMY G BOZEMANCredential: M.D.
Location Address507 N MAIN STSalem, AR 72576-9449
Mailing AddressPo Box 517Salem, AR 72576-0517 · (870) 895-6096 · Fax (870) 895-3833
Phone(870) 895-2541
Fax(870) 895-2957
Sole ProprietorNo
Enumeration DateMarch 1, 2006
Last NPPES UpdateFebruary 1, 2017
✔ NPI 1164499935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in AR · C-4579
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
507 N MAIN ST, Salem, AR 72576
Open in Google Maps ↗

Other Identifiers 6

Other127770000AR · Qualchoice
Medicare ID-Type Unspecified50573AR
Other200621605MO · Medicaid
Medicaid102258001AR
Other50573AR · Blue Cross Blue Shield
Medicare UPIND04380AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jimmy G Bozeman M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Jimmy Bozeman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Baxter Health Fulton County Hospital
1.7 mi
Emergency Medicine
679 N MAIN ST
Salem, AR 72576
  • Reassigned Medicare billing, Arkansas enrollment
  • 20 clinicians in this Medicare group
NPI 1841038825 (870) 895-2691
Fulton County Hospital
1.7 mi
Emergency Medicine
679 NORTH MAIN
Salem, AR 72576
  • Reassigned Medicare billing, Arkansas enrollment
  • 29 clinicians in this Medicare group
NPI 1831274612 (870) 895-2691

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

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CONNIE F. BRAY CRNA
Nurse Anesthetist, Certified Registered
507 N MAIN ST
SALEM, AR 72576
Fulton County (870) 895-2541
SALEM FAMILY CLINIC
General Practice
507 N MAIN ST
SALEM, AR 72576
Fulton County (870) 895-2541
DR. PAUL DAVID KAUFFMAN M.D.
Family Medicine
507 N MAIN ST
SALEM, AR 72576
Fulton County (870) 895-2541

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 Jimmy Bozeman's NPI number?

The NPI number for Jimmy Bozeman is 1164499935. It was assigned to this individual provider in the NPPES registry on March 1, 2006.

Where is Jimmy Bozeman located?

Jimmy Bozeman practices at 507 N Main St, Salem, AR 72576. The listed phone number is (870) 895-2541.

What is Jimmy Bozeman's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Jimmy Bozeman enrolled in Medicare?

Yes. Jimmy Bozeman is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jimmy Bozeman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jimmy Bozeman reassigns Medicare benefits to 2 organizations: Baxter Health Fulton County Hospital (Salem, AR) and Fulton County Hospital (Salem, AR). 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 Jimmy Bozeman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jimmy Bozeman accept?

Health plans from Health Advantage and Octave list Jimmy Bozeman 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 Jimmy Bozeman was last updated on February 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.