Scott Bolton, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9113109 Issued in FL

Practice address

19369 US Highway 19 N Apt 416
Clearwater, FL 33764-3317

Phone

(502) 292-7575

NPI assigned

Apr 7, 2020

Last updated

Mar 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Caring Community Counseling

  • Mental Health Counselor
  • St Petersburg, FL
  • NPI 1790191781
  NPD

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1275162612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19369 US HIGHWAY 19 N APT 416",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337643317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19369 US HIGHWAY 19 N APT 416",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337643317",
            "telephone_number": "502-292-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "FL",
            "license": "PA9113109",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9113109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bohrer Group LLC (Shore Lake Dental)
• Veronica F Bohrmann, CRNA
• Leeann Bolgen, FNP-C
• Nathaniel Matthew Bolli, M.D.
• Susan Bolourian, PT
• Andrew Boltuch, D.O.
• Breanna Bombard
• Katina Monet Bonaparte, MD
• Iara C Bonatto Caldeira, LMHC
• Irina Beatriz Bond

• Medical Physician Assistant in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.