Joshua Kyle Bolton

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110-004270 Issued in VA

Practice address

3000 Coliseum Dr
Hampton, VA 23666-5963

Phone

(757) 599-4922

NPI assigned

Jun 18, 2013

Last updated

Jun 7, 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment
• Emergency Physicians of St Petersburg PA

  • Emergency Medicine Physician
  • St Petersburg, FL
  • NPI 1851726566
  Medicare reassignment
• Shi Keys LLC

  • Emergency Medicine Physician
  • Tavernier, FL
  • NPI 1952903536
  Medicare reassignment
• Southwest Florida Emergency Management LLC

  • Emergency Medicine Physician
  • Naples, FL
  • NPI 1780911206
  Medicare reassignment
• Southwest Florida Emergency Physicians, PA

  • Emergency Medicine Physician
  • Fort Myers, FL
  • NPI 1588659502
  Medicare reassignment
• Thse - Marco Urgent Care LLC

  • Internal Medicine Physician
  • Marco Island, FL
  • NPI 1801125331
  Medicare reassignment
• Harbor Blvd Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Port Charlotte, FL
  • NPI 1700138997
  NPD (past)

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1689013260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-3292",
            "fax_number": "239-343-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 COLISEUM DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665963",
            "telephone_number": "757-599-4922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13681 Doctors Way",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124300",
            "country_code": "US",
            "telephone_number": "239-343-3292",
            "fax_number": "239-343-3695",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2776 Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015864",
            "country_code": "US",
            "telephone_number": "239-343-3292",
            "fax_number": "239-343-3695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "JOSHUA",
        "middle_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-18",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-004270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013228200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latrina Blue-Moody
• Kamron Blue, MSW
• Major K Boateng, MD
• Carrie Jean Boehnlein, C.M.T.
• Cynthia J Boland, LPC
• Cianni Bonhomme-Delavega, RBT
• Beverly Bonner, MSW
• Carol Bonner, PSY.D.
• Farrah S Bonney, FNP-C
• Ellen Booker, LCSW

• Physician Assistant in Hampton, VA
• Providers in Hampton, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.