Shannon Marie Bolten, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0099725 Issued in MD

Practice address

22 S Greene St # N5W70
Baltimore, MD 21201-1544

Phone

(410) 328-6960

Fax

(410) 328-0646

NPI assigned

Apr 2, 2021

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 MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Emergency Physicians SPPS

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1760885958
  Medicare reassignment NPD
• St. Paul Place Specialists, Inc.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Baltimore, MD
  • NPI 1871549196
  Medicare reassignment NPD
• Saint Paul Place Specialists, Inc.

  • Plastic and Reconstructive Surgery Physician
  • Baltimore, MD
  • NPI 1518913839
  NPD
• St Paul Place Specialists Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1497707681
  NPD
• University of Maryland Pediatric Assoc PA

  • Pediatric Allergy/Immunology Physician
  • Baltimore, MD
  • NPI 1912002320
  NPD
• University of Maryland Pediatric Associates, PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1083933444

  Pediatrics

  NPD
• University of Maryland Pediatric Associates, PA

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1528163912
  NPD
• Mercy Medical Center Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1144282583
  NPD (past)
• University of Maryland Medical Center, LLC

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1174660120
  NPD (past)

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1801474432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST # N5W70",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6960",
            "fax_number": "410-328-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST # N5W70",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6960",
            "fax_number": "410-328-0646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTEN",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0099725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guileon Deborah Patricia Bolou
• Bolpat Health Services
• Beverly G Bolster
• Ellen Bolt, AGACNP-BC
• Jason D. Bolt, CRNA
• Zachary T Bolten, MD
• Bolton Therapy & Wellness
• Bolum Logistics LLC
• Emily Bomasang-Layno, M.D.
• Michael Bombardier, PHD

• Pediatrics Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.