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JENNIFER CHISM BOLEN FNP-C
NPI 1639720550
Nurse Practitioner - Family in Ecru, MS

Active since September 23, 2019PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: September 23, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jennifer Chism Bolen Fnp-c NPPES

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

JENNIFER CHISM BOLEN FNP-C (NPI 1639720550) is an individual family provider in Ecru, Mississippi, licensed in Mississippi (F08191029) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1639720550
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJENNIFER CHISM BOLENCredential: FNP-C
Location Address5482 MS-15Ecru, MS 38841
Mailing Address5482 Ms-15Ecru, MS 38841 · (662) 488-8799
Phone(662) 488-8799
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateSeptember 23, 2019
✔ NPI 1639720550 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 MS · F08191029
5482 MS-15, Ecru, MS 38841
Open in Google Maps ↗

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

Jennifer Chism Bolen Fnp-c 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.

PECOS PAC ID2466888318
PECOS Enrollment IDI20200212001962
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 Jennifer Bolen reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Redmed, LLC
2.9 mi
Urgent Care
12 BROOKS XING
Pontotoc, MS 38863
  • Reassigned Medicare billing, Mississippi enrollment
  • 118 clinicians in this Medicare group
NPI 1437589157 (662) 489-4044
Physicians Urgent Care Of Corinth, LLC
50 mi
General Practice
2601 GETWELL RD STE 1
Corinth, MS 38834
  • Reassigned Medicare billing, Mississippi enrollment
  • 55 clinicians in this Medicare group
NPI 1316059405 (662) 287-7138
Signify Health, LLC
460 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Mississippi enrollment
  • 202 clinicians in this Medicare group
NPI 1689158487 (469) 466-7007

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 38841 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
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.

Other Providers at the Same Location NPPES 2

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

MEGAN SPRINGER HOWELL FNP
Nurse Practitioner (Family)
5482 MS-15
ECRU, MS 38841
Pontotoc County (662) 488-8799
PAIGE SPARKS
Nurse Practitioner (Family)
5482 MS-15
ECRU, MS 38841
Pontotoc County (662) 488-8799

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 Jennifer Bolen's NPI number?

The NPI number for Jennifer Bolen is 1639720550. It was assigned to this individual provider in the NPPES registry on September 23, 2019.

Where is Jennifer Bolen located?

Jennifer Bolen practices at 5482 Ms-15, Ecru, MS 38841. The listed phone number is (662) 488-8799.

What is Jennifer Bolen's specialty?

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

Is Jennifer Bolen enrolled in Medicare?

Yes. Jennifer Bolen 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 Jennifer Bolen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Bolen reassigns Medicare benefits to 3 organizations: Redmed, LLC (Pontotoc, MS), Physicians Urgent Care Of Corinth, LLC (Corinth, MS) and Signify Health, LLC (Dallas, TX). 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 Jennifer Bolen'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 Jennifer Bolen was last updated on September 23, 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.