Shantel Laniece Bolton, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95457 Issued in OK

Practice address

7600 S Lewis Ave
Tulsa, OK 74136-6836

Phone

(539) 399-3410

Fax

(539) 399-3419

NPI assigned

Mar 6, 2019

Last updated

Apr 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
• Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
• Direct secure messaging: sbolton914726@ahs.direct-ci.com

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.

• Ahs Oklahoma Physician Group LLC

  dba Utica Park Clinic

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775
  Medicare reassignment Care Compare group NPD
• Omni Medical Group Inc

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1174578249
  Medicare reassignment NPD
• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406
  Medicare reassignment NPD
• Ahs Oklahoma Physician Group, LLC

  dba Cushing Medical Specialist

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051
  NPD
• St. John Physicians, Inc

  dba Siggins Memorial Clinic

  • Rural Health Clinic/Center
  • Barnsdall, OK
  • NPI 1033176367
  NPD
• Ahs Hillcrest Medical Center, LLC

  dba Hillcrest Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  NPD (past)
• Ahs Southcrest Hospital, LLC

  dba HIllcrest Hospital South

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  NPD (past)

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

• Ahs Hillcrest Medical Center, LLC

  dba Hillcrest Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Ahs Southcrest Hospital, LLC

  dba HIllcrest Hospital South

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  Care Compare affiliation

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1487112603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366836",
            "telephone_number": "539-399-3410",
            "fax_number": "539-399-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366836",
            "telephone_number": "539-399-3410",
            "fax_number": "539-399-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "SHANTEL",
        "middle_name": "LANIECE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "95457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexia Bolte, MMFT
• Kristen Bolte
• Spenser Bolte
• Catherine Bolton
• Kathryn Elizabeth Bolton, PT
• Angela Dene Bolz, D.O.
• Jonathan Bomar, APRN-CRNA
• Mohammed Mazhar Mohammed Anwar Bombaywala
• Lauren Bomier
• Pavankumar Bommasamudram, M.D.

• Family Nurse Practitioner in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.
• 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.