Individual provider Active NPI

Pamela Kay Bolton, APRN

  • Family Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1801883871
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN1592302 Issued in FL
Practice address
22655 Bayshore Rd Ste 110
Port Charlotte, FL 33980-2005
Phone
(941) 235-4900
Fax
(941) 235-4901
NPI assigned
Oct 4, 2005
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN1592302 FL Primary
Oncology Clinical Nurse Specialist 364SX0200X APRN1592302 FL

Addresses

Primary practice location

22655 Bayshore Rd Ste 110
Port Charlotte, FL 33980-2005

Mailing address

PO Box 2147
Ft Myers, FL 33902-2147
Phone (239) 343-5333

Other practice location 1

9981 S Healthpark Dr
Suite 156
Ft Myers, FL 33908
Phone (239) 432-3333

Other identifiers 1

IdentifierTypeStateIssuer
306970200MedicaidFL

Other names 1

  • Pam Wojciki Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pwojciki2269@Direct.leememorial.org Lee Memorial Health System

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110509000879 FL Practitioner - Nurse Practitioner 1658557608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN1592302FLMDOncology Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Feb 15, 2011 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc Nurse Practitioner CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Nurse Practitioner CurrentSince Feb 15, 2011 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

9981 S Healthpark Dr
Ste 156
Fort Myers, FL 33908
Phone (239) 343-5333

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

22655 Bayshore Rd
Ste 110
Punta Gorda, FL 33980
Phone (941) 235-4900

Interoperability endpoints

  • Direct secure messaging: pwojciki2269@direct.leememorial.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1801883871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-5333",
            "fax_number": "239-343-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22655 BAYSHORE RD STE 110",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339802005",
            "telephone_number": "941-235-4900",
            "fax_number": "941-235-4901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9981 S Healthpark Dr",
            "address_2": "Suite 156",
            "address_purpose": "LOCATION",
            "city": "Ft Myers",
            "state": "FL",
            "postal_code": "33908",
            "country_code": "US",
            "telephone_number": "239-432-3333",
            "fax_number": "239-343-5321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "PAMELA",
        "middle_name": "KAY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN1592302",
            "primary": true
        },
        {
            "code": "364SX0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": "FL",
            "license": "APRN1592302",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306970200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwojciki2269@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PAM",
            "last_name": "WOJCIKI",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.