Active NPI
Samantha Bolton, RD
- Registered Dietitian
- Saint Augustine, FL
National Provider Identifier
1447125109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND12404
- Practice address
- 162 Tower CT
Saint Augustine, FL 32092-0292 - Phone
- (847) 528-0935
- NPI assigned
- Oct 10, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND12404 | FL | Primary |
Addresses
Primary practice location
162 Tower CT
Saint Augustine, FL 32092-0292
Mailing address
162 Tower CT
Saint Augustine, FL 32092-0292
Other names 1
- Samantha Czarnota
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND12404 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | 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": "1760054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760054400000",
"number": "1447125109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 TOWER CT",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320920292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 TOWER CT",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320920292",
"telephone_number": "847-528-0935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTON",
"first_name": "SAMANTHA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-10-10",
"last_updated": "2025-10-10",
"certification_date": "2025-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND12404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SAMANTHA",
"last_name": "CZARNOTA",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Saint Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.