GINA BOLTON FARLEY – Family Nurse Practitioner, NPI 1336687078

GINA BOLTON FARLEY is a healthcare provider. based in Southside, Alabama. specializing in NURSE PRACTITIONER. They hold a License No. 1-122037 (AL). The NPI Number for GINA BOLTON FARLEY is 1336687078

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
GINA BOLTON FARLEY
NPI
1336687078
Phone
(256) 490-9304
Address
5895 KATHERINE ST
Enumeration Date
2 February 2017
Last Update Date
2 February 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2565466200
Graduation Year
2016 (10 years ago)
PAC ID
4486905064
Group Practice PAC ID
1658320940
Professional Enrollment ID
I20180920001346
Address ID
AL359015103GA503XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

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Provider Addresses for GINA BOLTON FARLEY

  • Katherine Street, Southside, Etowah County, Alabama, 35907, United States

    SOUTHSIDE, AL 359070005

    Phone: (256) 490-9304

    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: 2018-09-20

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
I20180920001346INurse 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 35907)

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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: 1658320940View full group profile
NameSpecialtyState
-AL
Nurse PractitionerGA
Cardiovascular Disease (Cardiology)AL
Cardiovascular Disease (Cardiology)AL

Reviews

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Frequently asked questions

What number should I use to identify GINA BOLTON FARLEY for billing?
Administrative and clinical systems typically use NPI 1336687078 for GINA BOLTON FARLEY.
Is GINA BOLTON FARLEY currently accepting referrals based on NPI status?
Registry metadata lists GINA BOLTON FARLEY as active.
What services align with GINA BOLTON FARLEY's listing?
GINA BOLTON FARLEY's public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to GINA BOLTON FARLEY?
The directory associates GINA BOLTON FARLEY with Southside, Alabama. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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