DR. MATTHEW BOLTON MD
NPI 1720082548
General Practice in Crossville, TN

Q: What is Matthew Bolton's NPI number?

The NPI number for Matthew Bolton is 1720082548. It was assigned to this individual provider in the NPPES registry on June 9, 2005.

Q: What is Matthew Bolton's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Bolton was last updated on March 17, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 09, 2005PECOS Enrolled

1503 S MAIN ST, CROSSVILLE, TN 38555(931) 484-6196(931) 456-1047 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 17, 2018, Mar 8, 2018, Feb 12, 2018 (3 updates tracked since 2018).

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About Dr. Matthew Bolton Md NPPES

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

DR. MATTHEW BOLTON MD (NPI 1720082548) is an individual general practice provider in Crossville, Tennessee, licensed in Tennessee (MD21614) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in Cookeville.

NPPES Registry Identity

NPI1720082548

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameDR. MATTHEW BOLTONCredential: MD

Location Address1503 S MAIN STCrossville, TN 38555-5967

Mailing Address1100 England DrCookeville, TN 38501-0924 · (931) 528-7531 · Fax (931) 520-0413

Phone(931) 484-6196

Fax(931) 456-1047

Sole ProprietorNo

Enumeration DateJune 9, 2005

Last NPPES UpdateMarch 17, 20183 updates tracked since enumeration

✔ NPI 1720082548 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in TN · MD21614

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedFamily MedicineTaxonomy 207Q00000X · License 21614 (TN)

1503 S MAIN ST, Crossville, TN 38555

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Secondary Practice Location 1

Location 1701 County Services DrCookeville, TN 38501-4338 · Phone (931) 520-2531

Other Identifiers 1

Other4129250TN · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Matthew Bolton Md 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.

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Other Providers at the Same Location NPPES 20

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

MRS. MICHAELA DAVIS RN

Registered Nurse