MITCHELL BOLES (APRN) – Acute Care Nurse Practitioner, NPI 1003470402

MITCHELL BOLES (APRN) is a healthcare provider. based in Newnan, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. RN233677 (GA). The NPI Number for MITCHELL BOLES (APRN) is 1003470402

Main info

Male
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
MITCHELL BOLES (APRN)
NPI
1003470402
Phone
(770) 252-7557
Address
1665 HIGHWAY 34 E STE 100
Enumeration Date
1 May 2019
Last Update Date
15 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7704006080
Graduation Year
2019 (7 years ago)
PAC ID
2860826963
Group Practice PAC ID
4880841212
Professional Enrollment ID
I20191226000624
Address ID
GA302658001NE600XXPKWY400

Contacts

Secure Messaging
mboles@gapaincare.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness85
Years active:7State licenses:1Other namesUpdated within 12 months

9,652 NURSE PRACTITIONER in GA

Provider Addresses for MITCHELL BOLES (APRN)

  • 1665 HIGHWAY 34 E STE 100

    NEWNAN, GA 302652404

    Phone: (770) 252-7557

    Type: Mailing

  • 105A Corporate Plaza Dr

    LaGrange, GA 302412801

    Phone: (678) 800-0099

    Fax: (770) 252-7513

    Type: Location

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: 2019-12-26

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
I20191226000624INurse PractitionerGATBD

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 30265)

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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: 4880841212View full group profile

Reviews

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Frequently asked questions

How do I look up MITCHELL BOLES (APRN) by NPI?
Use NPI 1003470402 when you need to reference MITCHELL BOLES (APRN) in forms, claims, or directories.
Is MITCHELL BOLES (APRN) currently active in the NPI registry?
CMS-published data lists MITCHELL BOLES (APRN) as an active registrant.
Does MITCHELL BOLES (APRN) list a primary specialty?
If you are matching referrals, note Acute Care Nurse Practitioner for MITCHELL BOLES (APRN). Clinical services aligned with this taxonomy classification.
What location metadata exists for MITCHELL BOLES (APRN)?
The page summarizes Newnan, Georgia for MITCHELL BOLES (APRN); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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