MRS. WILLIE MARY BOLDEN
NPI 1518428283
Nurse Practitioner - Family in Shaw, MS
About Mrs. Willie Mary Bolden NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. WILLIE MARY BOLDEN (NPI 1518428283) is an individual family provider in Shaw, Mississippi, licensed in Mississippi (903205) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2018).
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 and accepts Medicare assignment
Mrs. Willie Mary Bolden is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
7Medicare enrollment records show Willie Mary Bolden reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Shaw, MS 38773
- Reassigned Medicare billing, Mississippi enrollment
- 11 clinicians in this Medicare group
Shaw, MS 38773
- Reassigned Medicare billing, Mississippi enrollment
- 4 clinicians in this Medicare group
Cleveland, MS 38732
- Reassigned Medicare billing, Mississippi enrollment
- 28 clinicians in this Medicare group
Greenville, MS 38703
- Reassigned Medicare billing, Mississippi enrollment
- 123 clinicians in this Medicare group
Aberdeen, MS 39730
- Reassigned Medicare billing, Mississippi enrollment
- Also billed through NPI 1285164046 (Mississippi)
- 168 clinicians in this Medicare group
Ripley, MS 38663
- Reassigned Medicare billing, Mississippi enrollment
- 463 clinicians in this Medicare group
Hoover, AL 35216
- Reassigned Medicare billing, Mississippi enrollment
- 207 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 38773 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 7
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 Willie Mary Bolden's NPI number?
The NPI number for Willie Mary Bolden is 1518428283. It was assigned to this individual provider in the NPPES registry on March 26, 2019.
Where is Willie Mary Bolden located?
Willie Mary Bolden practices at 112 W Peeler Ave, Shaw, MS 38773. The listed phone number is (662) 745-6638.
What is Willie Mary Bolden's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Willie Mary Bolden enrolled in Medicare?
Yes. Willie Mary Bolden is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Willie Mary Bolden's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Willie Mary Bolden reassigns Medicare benefits to 7 organizations: Shaw Family Medical, LLC (Shaw, MS), Making Moves In The Community, Incorporated (Shaw, MS), Delta Health Center, Inc (Cleveland, MS), Delta Medical Group (Greenville, MS), Boa Vida Hospital Of Aberdeen, Ms LLC (Aberdeen, MS) and 2 more organizations, listed in the Medicare section above. 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 Willie Mary Bolden's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Willie Mary Bolden accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 4 other insurers list Willie Mary Bolden 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 Willie Mary Bolden was last updated on March 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Mrs. Willie Mary Bolden · NPI 1518428283
Family physician in Shaw, Mississippi. Individual provider, active in the CMS NPPES registry since March 26, 2019.
## Identity
- **NPI:** 1518428283 (Entity type: Individual)
- **Enumerated:** March 26, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 903205 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 112 W PEELER AVE, Shaw, MS 38773-8710
- **Phone:** (662) 745-6638
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 7 organizations under Medicare reassignment (form CMS-855R): Shaw Family Medical, LLC (NPI 1750642633, Shaw, MS); Making Moves In The Community, Incorporated (NPI 1851884266, Shaw, MS); Delta Health Center, Inc (NPI 1285951970, Cleveland, MS); Delta Medical Group (NPI 1790701134, Greenville, MS); Boa Vida Hospital Of Aberdeen, Ms LLC (NPI 1467115279, Aberdeen, MS); and 2 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** March 26, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1518428283) · Data from the CMS NPPES public registry.