Individual provider Active NPI

Sherie M Kolakowski, APRN

  • Family Nurse Practitioner
  • Naples, FL
National Provider Identifier
1205551918
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11021769 Issued in FL
Practice address
6609 Willow Park Dr Ste 100
Naples, FL 34109-9015
Phone
(239) 643-9977
Fax
(239) 596-2743
NPI assigned
Oct 5, 2022
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11021769 FL Primary

Addresses

Primary practice location

6609 Willow Park Dr Ste 100
Naples, FL 34109-9015

Mailing address

6609 Willow Park Dr Ste 100
Naples, FL 34109-9015
Phone (239) 643-9977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221012003820 FL Practitioner - Nurse Practitioner 4385010586 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11021769FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Naples Interventional Cardiac Electrophysiology, LLC CurrentSince Oct 5, 2022 Accepting new patients

Locations

311 Tamiami Trl N
Ste 201
Naples, FL 34102
Phone (239) 624-0030

6609 Willow Park Dr
Ste 100
Naples, FL 34109
Phone (239) 643-9977

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1205551918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6609 WILLOW PARK DR STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341099015",
            "telephone_number": "239-643-9977",
            "fax_number": "239-596-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 WILLOW PARK DR STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341099015",
            "telephone_number": "239-643-9977",
            "fax_number": "239-596-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLAKOWSKI",
        "first_name": "SHERIE",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11021769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.