Stephanie Elizabeth Bolton, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

30996 Issued in TN

Practice address

7345 Courage Way Ste 1
Chattanooga, TN 37421-1555

Phone

(423) 602-9797

Fax

(423) 602-9796

NPI assigned

Nov 21, 2019

Sex

Female

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

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Scenic City Alliance of Psychiatry and Psychotherapy PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chattanooga, TN
  • NPI 1144788753
  Medicare reassignment NPD

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1275179574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24927",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374224927",
            "telephone_number": "423-643-2576",
            "fax_number": "423-648-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 COURAGE WAY STE 1",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211555",
            "telephone_number": "423-602-9797",
            "fax_number": "423-602-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "STEPHANIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-21",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "30996",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "229228",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tess Bolletta, FNP-C
• Vani Bollineni, MD
• Deanne Bolton
• James P Bolton, MD
• Spencer Madison Bolton, PHARMD
• Drexel Bond, CPM-TN, LM
• Morgan Bonds
• Rachel Bone, CRNA
• Melody Bonilla
• Mark R. Bonnell, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.