Judith A Bolton, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704075734 Issued in MI

Practice address

205 North East Avenue
Jackson, MI 49201-1753

Phone

(517) 788-4963

NPI assigned

Nov 14, 2006

Last updated

Nov 19, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1851410005
  NPD
• Straith Hospital for Special Surgery

  • General Acute Care Hospital
  • Southfield, MI
  • NPI 1710037221
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1922170943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 W DELHI RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039010",
            "telephone_number": "734-769-4809",
            "fax_number": "734-769-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 NORTH EAST AVENUE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-788-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704075734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA AANA",
            "identifier": "018136",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Joyce Bolanowski, LLMSW
• Kristina Bolante, PT
• Cheyenne Tayler Bolenbaugh, CTRS
• Brandon James Bolin
• Makayla Bolin
• Kimberly Kay Bomar, BSW, MS, LLMSW
• Rebekka Bommarito, LPC
• Samuel Bommarito, LLPC
• Trisha Bond
• Stacy Bondsteel

• Certified Registered Nurse Anesthetist in Jackson, MI
• Providers in Jackson, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.