NPIMap

Individual provider Active NPI

Nicole Bolt, CRNA

  • Certified Registered Nurse Anesthetist
  • Gastonia, NC
National Provider Identifier
1376182261
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
298943 Issued in NC
Practice address
2525 Court Dr
Gastonia, NC 28054-2140
Phone
(770) 862-1785
NPI assigned
Dec 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 27242 SC
Certified Registered Nurse Anesthetist 367500000X 298943 NC Primary

Addresses

Primary practice location

2525 Court Dr
Gastonia, NC 28054-2140

Mailing address

1305 Central Ave Apt 140
Charlotte, NC 28205-5188
Phone (870) 405-4424

Other practice location 1

7 Independence Pt Ste 300
Greenville, SC 29615-4569
Phone (864) 522-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628004548 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921433699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7 Independence PT
Suite 300
Greenville, SC 29615-4569
Phone (864) 522-3700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
298943NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jun 19, 2023 Accepting new patients
Prisma Health University Medical Group Anesthesiology CurrentSince Jun 19, 2023 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients

Locations

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

7 Independence Pt
Ste 300
Greenville, SC 29615
Phone (864) 522-3700

Organizations & group practices 3

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.

Hospital & facility affiliations 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1376182261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 CENTRAL AVE APT 140",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055188",
            "telephone_number": "870-405-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542140",
            "telephone_number": "770-862-1785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Independence Pt Ste 300",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296154569",
            "country_code": "US",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLT",
        "first_name": "NICOLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-26",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "27242",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "298943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.