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MRS. JACQUELINE BOLMER NP-C
NPI 1619236908
Nurse Practitioner - Family in Mount Orab, OH

Active since May 08, 2012PECOS Enrolled
100/100
CMS Quality Rating
210 STERLING RUN BLVD, MOUNT ORAB, OH 45154(615) 425-4200 Get Directions Write a Review

NPPES record last updated: May 8, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Jacqueline Bolmer Np-c NPPES

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

MRS. JACQUELINE BOLMER NP-C (NPI 1619236908) is an individual family provider in Mount Orab, Ohio, licensed in Ohio (COA.13279-NP) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619236908
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. JACQUELINE BOLMERCredential: NP-C
Location Address210 STERLING RUN BLVDMount Orab, OH 45154-8350
Mailing Address2620 Elm Hill PikeNashville, TN 37214-3108 · (615) 425-4200 · Fax (615) 425-4268
Phone(615) 425-4200
Sole ProprietorNo
Enumeration DateMay 8, 2012
✔ NPI 1619236908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OH · COA.13279-NP
210 STERLING RUN BLVD, Mount Orab, OH 45154
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Other Names 1

Former Name (1)Jacqueline Jacobs

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Jacqueline Bolmer Np-c 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

3

Medicare enrollment records show Jacqueline Bolmer reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Little Clinic Of Ohio LLC
36 mi
Family
7132 HAMILTON AVE
Cincinnati, OH 45231
  • Reassigned Medicare billing, Ohio enrollment
  • 537 clinicians in this Medicare group
NPI 1982761896 (513) 728-2780
Molina Care Connections, LLC.
1,933 mi
Nurse Practitioner
200 OCEANGATE STE 100
Long Beach, CA 90802
  • Reassigned Medicare billing, Illinois, Kentucky, Michigan, Nebraska, Ohio and South Carolina enrollments
  • 74 clinicians in this Medicare group
NPI 1407243223 (888) 562-5442
Southeast Alaska Regional Health Consortium
2,431 mi
Clinic/Center
SUNRISE LODGE
Edna Bay, AK 99901
  • Reassigned Medicare billing, Texas enrollment
  • 640 clinicians in this Medicare group
NPI 1518403906 (907) 874-4700

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45154 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 12

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

ZACHARY RYAN MARSH PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
210 STERLING RUN BLVD
MOUNT ORAB, OH 45154
Brown County (937) 444-6911
KROGER LIMITED PARTNERSHIP I
Pharmacy (Community/Retail Pharmacy)
210 STERLING RUN BLVD
MOUNT ORAB, OH 45154
Brown County (937) 444-5014
DR. AUTUMN LOUISE PRESTON PHARMD
Pharmacist
210 STERLING RUN BLVD
MOUNT ORAB, OH 45154
Brown County (937) 444-5014
MRS. TINA WAGNER PHARMD
Pharmacist
210 STERLING RUN BLVD
MOUNT ORAB, OH 45154
Brown County (937) 444-6911
MR. MITCHELL SMITH MCMANIS MSN, APRN, CNP
Nurse Practitioner (Family)
210 STERLING RUN BLVD
MOUNT ORAB, OH 45154
Brown County (937) 444-6910
DR. JESSE ALEXANDER CUMBERLEDGE PHARMD, RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
210 STERLING RUN BLVD
MOUNT ORAB, OH 45154
Brown County (937) 444-6911
DR. VICTORIA SHANNON PHARMD
Pharmacist
210 STERLING RUN BLVD
MOUNT ORAB, OH 45154
Brown County (937) 444-6911
DEREK BOWLES PHARMD
Pharmacist
210 STERLING RUN BLVD
MOUNT ORAB, OH 45154
Brown County (937) 444-6911

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 Jacqueline Bolmer's NPI number?

The NPI number for Jacqueline Bolmer is 1619236908. It was assigned to this individual provider in the NPPES registry on May 8, 2012. The provider is also known as Jacqueline Jacobs.

Where is Jacqueline Bolmer located?

Jacqueline Bolmer practices at 210 Sterling Run Blvd, Mount Orab, OH 45154. The listed phone number is (615) 425-4200.

What is Jacqueline Bolmer's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jacqueline Bolmer enrolled in Medicare?

Yes. Jacqueline Bolmer is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jacqueline Bolmer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Bolmer reassigns Medicare benefits to 3 organizations: The Little Clinic Of Ohio LLC (Cincinnati, OH), Molina Care Connections, LLC. (Long Beach, CA) and Southeast Alaska Regional Health Consortium (Edna Bay, AK). 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 Jacqueline Bolmer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacqueline Bolmer was last updated on May 8, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.