Individual provider Active NPI

Sharon Bolaji-Thomas

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1194941831
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344896 Issued in NY
Practice address
222 Alexander St Ste 3000
Rochester, NY 14607
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN545546 PA
Family Nurse Practitioner 363LF0000X 344896 NY Primary

Addresses

Primary practice location

222 Alexander St Ste 3000
Rochester, NY 14607

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-8350

Other practice location 1

2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047
Phone (610) 834-1122 ext. 133

Other practice location 2

2300 W Ridge Rd
Rochester, NY 14626-2800
Phone (585) 922-8350

Other practice location 3

10 Hagen Dr Ste 20
Rochester, NY 14625-2663
Phone (585) 922-8350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN545546PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Supreme Nurses LLC PastSince Mar 7, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1194941831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-8350",
            "fax_number": "585-922-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 ALEXANDER ST STE 3000",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2250 Hickory Rd",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "Plymouth Meeting",
            "state": "PA",
            "postal_code": "194621047",
            "country_code": "US",
            "telephone_number": "610-834-1122 x133",
            "fax_number": "610-834-7525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 W Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146262800",
            "country_code": "US",
            "telephone_number": "585-922-8350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Hagen Dr Ste 20",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146252663",
            "country_code": "US",
            "telephone_number": "585-922-8350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLAJI-THOMAS",
        "first_name": "SHARON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN545546",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.