TANNIS JEANETTE BOLTON (PA) – Physician Assistant, NPI 1629092861
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for TANNIS JEANETTE BOLTON (PA)
1701 Magnolia Way Ste 102
Augusta, GA 309099484
Phone: (706) 992-6699
Fax: (706) 868-5027
Type: Location
PO BOX 19305
CHARLOTTE, NC 282199305
Phone:
Type: Mailing
1656 RIVERCHASE BLVD
STE 1800
ROCK HILL, SC 297322084
Phone: (803) 909-1850
Type: Location
PO BOX 2510
EVANS, GA 308092510
Phone: (706) 922-8251
Fax: (706) 922-6695
Type: Mailing
131 RINEHART WAY
AIKEN, SC 298031703
Phone: (803) 335-2200
Fax: (803) 649-7966
Type: Location
Bay Area Hospital, 1775, Thompson Road, Coos Bay, Coos County, Oregon, 97420, United States
COOS BAY, OR 974202125
Phone: (541) 269-8111
Type: Mailing
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: 2022-09-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20151118003138 | I | Physician Assistant | OR | TBD |
| I20220916000446 | I | Physician Assistant | SC | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 146 | 138 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 138 | 134 | $0 |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 56 | 56 | $0 |
| 81003 | Automated urinalysis test | 52 | 51 | $0 |
| 94640 | Inhalation treatment for airway obstruction or sputum production | 26 | 22 | $0 |
Insurance plans in this area (ZIP 30909)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | SC | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| - | GA | |
| Family Practice | GA | |
| Family Practice, Emergency Medicine | GA | |
| Family Practice | GA | |
| Hospitalist, Family Practice | GA |
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