BOLIVAR PHYSICIAN PRACTICES LLC
NPI 1205489689
Clinic/Center - Rural Health in Rosedale, MS
About Bolivar Physician Practices Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BOLIVAR PHYSICIAN PRACTICES LLC (NPI 1205489689), doing business as Rosedale Family Medical, is a healthcare organization registered as a rural health in Rosedale, Mississippi and active in the NPI registry since July 2019. The organization lists Charlotte Lawrence, Secretary, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 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)
Bolivar Physician Practices Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
42Medicare enrollment records show 42 clinicians reassign Medicare billing to Bolivar Physician Practices LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 8
Nearest to this location (20)
See all 42Source: 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 1205489689. It was assigned to this organization in the NPPES registry on July 24, 2019. The provider is doing business as Rosedale Family Medical.
Where is Bolivar Physician Practices LLC located?
Bolivar Physician Practices LLC is located at 512 Levee St, Rosedale, MS 38769. The listed phone number is (662) 759-6806.
What is Bolivar Physician Practices LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
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, 1 practice 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.
# Bolivar Physician Practices Llc · NPI 1205489689
Rural Health organization in Rosedale, Mississippi. Organization record, active in the CMS NPPES registry since July 24, 2019.
## Identity
- **NPI:** 1205489689 (Entity type: Organization)
- **Enumerated:** July 24, 2019
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Also known as:** Rosedale Family Medical (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Charlotte Lawrence, SECRETARY
## Practice location
- **Address:** 512 LEVEE ST, Rosedale, MS 38769-5507
- **Phone:** (662) 759-6806 · **Fax:** (662) 759-6771
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 42 clinicians in 8 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (15), Obstetrics/Gynecology (7), General Surgery (6); 1 practice within 10 miles; [full list](https://npiprofile.com/npi/1205489689/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 4, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1205489689) · Data from the CMS NPPES public registry.