1. Home
  2. Directory
  3. Mississippi
  4. Cleveland
  5. Otolaryngology
  6. NPI Profile

BOLIVAR PHYSICIAN PRACTICES LLC
NPI 1386076800
Otolaryngology in Cleveland, MS

Active since August 07, 2013
903 E SUNFLOWER RD, SUITE 400, CLEVELAND, MS 38732(662) 545-3205(662) 545-3204 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Bolivar Physician Practices Llc NPPES

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

BOLIVAR PHYSICIAN PRACTICES LLC (NPI 1386076800), doing business as Bolivar Ent, is a healthcare organization registered as an otolaryngology in Cleveland, Mississippi and active in the NPI registry since August 2013. The organization lists Charlotte Lawrence, Secretary, as its authorized official.

NPPES Registry Identity

NPI1386076800
Entity TypeOrganization
Primary Taxonomy207Y00000X
Legal Business NameBOLIVAR PHYSICIAN PRACTICES LLC
Location Address903 E SUNFLOWER RD, SUITE 400Cleveland, MS 38732-2835
Mailing Address903 E Sunflower Rd Ste 400Cleveland, MS 38732-2836 · (662) 545-3205 · Fax (662) 545-3204
Phone(662) 545-3205
Fax(662) 545-3204
Organization SubpartNo
Authorized OfficialCharlotte LawrenceSecretary · (615) 920-7000
Enumeration DateAugust 7, 2013
Last NPPES UpdateJune 4, 2026
NPPES CertifiedJune 4, 2026
✔ NPI 1386076800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
903 E SUNFLOWER RD, Cleveland, MS 38732
Open in Google Maps ↗

Other Names 1

Doing Business AsBolivar Ent

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

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, 1 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
Derek Miles, MD
Urology
NPI 1407887391
907 E SUNFLOWER RD SUITE 103
Cleveland, MS 38732
(662) 846-9990
✔ PECOS✔ Accepts MedicareSame address
Maghan Ashmore, FNP-BC
Nurse Practitioner
NPI 1720624430
810 E SUNFLOWER RD STE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare0.1 mi
Charles Brock, M.D.
Family Practice
NPI 1689761280
810 E SUNFLOWER RD
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare0.1 mi
Steven Clark, M.D
Internal Medicine
NPI 1053408476
810 E SUNFLOWER RD
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare0.1 mi
Keila Mayfield, FNP
Nurse Practitioner
NPI 1235709494
810 E. SUNFLOWER ROAD SUITE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare0.1 mi
Clare Moore, FNP
Nurse Practitioner
NPI 1104332089
810 E SUNFLOWER RD
Cleveland, MS 38732
(662) 579-0136
✔ PECOS✔ Accepts Medicare0.1 mi
Brooke Tims, RN, CFNP
Nurse Practitioner
NPI 1477575561
810 E SUNFLOWER RD STE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare0.1 mi
Bennie Wright, M.D.
General Surgery
NPI 1992857106
810 E SUNFLOWER RD SUITE 100A
Cleveland, MS 38732
(662) 846-6015
✔ 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 Medicare0.1 mi
Bradley Baugh, MD
Obstetrics/Gynecology
NPI 1285728626
801 FIRST ST
Cleveland, MS 38732
(662) 843-0880
✔ PECOS✔ Accepts Medicare1.2 mi
Mark Blackwood, MD
Obstetrics/Gynecology
NPI 1558456764
801 FIRST ST
Cleveland, MS 38732
(662) 843-0880
✔ PECOS✔ Accepts Medicare1.2 mi
Matthew Bear, DO
Internal Medicine
NPI 1023646403
810 EAST SUNFLOWER RD SUITE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare1.2 mi
Angela Parish, CFNP
Nurse Practitioner
NPI 1144241910
810 E SUNFLOWER RD STE 100E
Cleveland, MS 38732
(662) 846-6034
✔ PECOS1.2 mi
Zachary Watters
Internal Medicine
NPI 1871243261
810 E SUNFLOWER RD
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare1.2 mi
John Carr, MD
Thoracic Surgery
NPI 1457353658
810 E SUNFLOWER RD STE 100A
Cleveland, MS 38732
(662) 579-0118
✔ PECOS✔ Accepts Medicare1.2 mi
Stephanie Hodnett
Nurse Practitioner
NPI 1679028377
801 1ST ST
Cleveland, MS 38732
(985) 892-7070
✔ PECOS✔ Accepts Medicare1.2 mi
Jacquanne Barnes, NP
Nurse Practitioner
NPI 1972562114
810 E SUNFLOWER RD SUITE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS✔ Accepts Medicare1.3 mi
David Walt, MD
Internal Medicine
NPI 1205895448
810 E SUNFLOWER RD SUITE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS1.3 mi
Paul Warrington, MD
Family Practice
NPI 1831168350
810 E SUNFLOWER RD SUITE 100A
Cleveland, MS 38732
(662) 843-3606
✔ PECOS1.3 mi
Brooke Scallion, FNP-C
Nurse Practitioner
NPI 1609385392
125 N MAIN ST
Drew, MS 38737
(662) 649-6045
✔ PECOS✔ Accepts Medicare12 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 1386076800. It was assigned to this organization in the NPPES registry on August 7, 2013. The provider is doing business as Bolivar ENT.

Where is Bolivar Physician Practices LLC located?

Bolivar Physician Practices LLC is located at 903 E Sunflower Rd Suite 400, Cleveland, MS 38732. The listed phone number is (662) 545-3205.

What is Bolivar Physician Practices LLC's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

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 at this address and 19 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.