Jordan Bolen, DO
NPI 1205695640 · Student in an Organized Health Care Education/Training Program · Saint Louis, MO
Enrolled with Medicare as Order and Referring Only - Pediatric Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jordan Bolen, DO is a Student in an Organized Health Care Education/Training Program provider in Saint Louis, MO (NPI 1205695640).
Provider details
- NPI number
- 1205695640
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- DO
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-03-18
- Last updated
- 2024-04-08
- Certified
- 2024-04-08
Frequently asked questions
- What is Jordan Bolen's NPI number?
- Jordan Bolen's National Provider Identifier (NPI) is 1205695640, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jordan Bolen's specialty?
- Jordan Bolen is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Jordan Bolen located?
- Jordan Bolen's practice location on file with NPPES is 1465 S Grand Blvd Rm 2717, Saint Louis, MO 63104-1003.
- What is Jordan Bolen's phone number?
- The practice phone number listed in the NPPES registry for Jordan Bolen is (314) 577-5634.
- Does Jordan Bolen accept Medicare?
- Jordan Bolen is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jordan Bolen's NPI active?
- Yes — Jordan Bolen's NPI (1205695640) is active in the NPPES registry as of the last update on 2024-04-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.