ANGELA BOLEN (FNP-C) – Family Nurse Practitioner, NPI 1154160406

ANGELA BOLEN (FNP-C) is a healthcare provider. based in Jackson, Alabama. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 1-102373 (AL). The NPI Number for ANGELA BOLEN (FNP-C) is 1154160406

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
ANGELA BOLEN (FNP-C)
NPI
1154160406
Phone
(251) 246-9021
Address
220 HOSPITAL DR
Enumeration Date
24 May 2024
Last Update Date
25 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2512461159
Graduation Year
2024 (2 years ago)
PAC ID
9133643901
Group Practice PAC ID
2062950199
Professional Enrollment ID
I20250414002437
Address ID
AL365452459JA220XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

Provider Addresses for ANGELA BOLEN (FNP-C)

  • 220 HOSPITAL DR

    JACKSON, AL 365452459

    Phone: (251) 246-9021

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250414002437INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36545)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062950199View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YFL
General Practice, General Surgery, General PracticeFL
Thoracic Surgery, Cardiac Surgery, Emergency Medicine, Vascular SurgeryAL
Emergency MedicineAL

Reviews

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Frequently asked questions

Is there an official ID for ANGELA BOLEN (FNP-C) in U.S. healthcare records?
The official identifier for ANGELA BOLEN (FNP-C) is NPI 1154160406.
Is ANGELA BOLEN (FNP-C) shown as active in public data?
Registry records indicate ANGELA BOLEN (FNP-C) maintains an active NPI.
What clinical focus is listed for ANGELA BOLEN (FNP-C)?
At a glance, ANGELA BOLEN (FNP-C) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is ANGELA BOLEN (FNP-C) located near Jackson?
ANGELA BOLEN (FNP-C) currently maps to Jackson, Alabama in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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