CMS-1500 Box 24J / 33a • NPI
1225534027
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207P00000X (CMS 93)
Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)
Box 32 Service Location & ZIP+4
200 STAHLHUT DR, LINCOLN, IL, 62656-5066
✓ 9-Digit EDI 837 ZIP+4 (62656-5066)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1225534027 (KYLEY JO BOLK, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
✓ Eligible
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1225534027)
Medicare Beneficiaries
187
Total Billed Services
248
Distinct CPT/HCPCS Codes
21
Medicare Allowed Total
$29,972.40
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1225534027 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KYLEY JO BOLK, MD |
| Plain-English Specialty | Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: 207P00000X (Emergency Medicine) |
| Certifying / Licensing Body | American Board of Emergency Medicine (ABEM) |
| Practice Location Address | 200 STAHLHUT DR, LINCOLN, IL, 62656-5066 |
| Practice Telephone / Fax | Tel: (217) 732-2161 |
| Administrative Mailing Address | 200 STAHLHUT DR, LINCOLN, IL, 62656-5066 |
| Enumeration & Last Sync | Enumerated: 2018-04-02 | CMS Record Updated: 2026-09-03 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207P00000X)
What Does Taxonomy Code 207P00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207P00000X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KYLEY JO BOLK, MD)
Typical CPT / Diagnostic Procedures:- Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
- Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
- Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting
- Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
- Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
- Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207P00000X — Emergency MedicinePlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: GA | License: 95628 | Primary: Secondary |
207P00000X — Emergency MedicinePlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: IL | License: 036.170428 | Primary: Yes (Primary) |
207P00000X — Emergency MedicinePlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: LA | License: 327880 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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