NICOLE R MERCER BOLTON


Address: 1990 Connecticut Ave S, Sartell, MN 56377-2554
Phone: 3202575595

NICOLE R MERCER BOLTON (NPI# 1881890549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881890549
Entity Type Individual
Full Name NICOLE R MERCER BOLTON
Credential M.D.
Practice Address 1990 Connecticut Ave S
Sartell
MN 56377-2554
Mailing Address Po Box 7366
Saint Cloud
MN 56302-7366
Practice Telephone 3202575595
Practice Fax Number 3202575596
Mailing Telephone 3202575595
Mailing Fax Number 3202575596
Enumeration Date 2007-06-21
Last Update Date 2011-09-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
53816 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MN 1881890549 05

Office Location

Street Address 1990 CONNECTICUT AVE S
City SARTELL
State MN
Zip Code 56377-2554

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306846076 Jody Allison Bolton Smith Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2005-07-26
1457881021 Angela Marie Schuster Physician Assistant 1990 Connecticut Ave S, Sartell, MN 56377-2554 2017-06-15
1104192541 James Dickinson Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2012-03-30
1467761130 Nathan B Danielson Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2010-09-29
1487965109 Scott Klettke Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2010-06-28
1487819751 Francis X. Kigozi Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2008-07-25
1598925539 Darrin John Spoden Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2008-06-12
1710150321 Leslie Hartman Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2008-04-04
1972782951 Chadd James Mcmahon Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2007-10-26
1811105182 Mohammad Asif Dogar Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2007-05-19
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235783515 Chae Norman Massage Therapist 303 4th Ave S, Suite C, Sartell, MN 56377 2019-07-25
1497317259 Stephanie Maria Schaefer Behavioral Analyst 1133 Mockingbird Loop, Sartell, MN 56377 2019-07-02
1538722848 Madison Toughill Behavior Technician 205 14th Ave E, Sartell, MN 56377 2019-04-22
1902388671 Julie Ann Helms Counselor 101 Dehler Dr., Sartell, MN 56377 2018-08-30
1104337617 Louis Chester Winskowski IIi Orthotist 50 14th Ave E Suite 114, Sartell, MN 56377 2017-10-24
1962958611 Centracare Clinic Exclusive Provider Organization 166 19th Street S, Suite 202, Sartell, MN 56377 2016-08-31
1295197846 Mindful Healing & Training Counselor 1417 15th Street South, Sartell, MN 56377 2016-03-23
1710342894 Saint Cloud Hospital St. Benedict's Senior Community Skilled Nursing Facility 990 19th St. S., Sartell, MN 56377 2015-12-16
1932452661 David Peter Pogatchnik Pharmacist 2251 Connecticut Ave. South, Health Partners Central Minnesota Clinics (pharmacy), Sartell, MN 56377 2012-10-18
1669759866 Lakewood Health System Clinic/Center 161 19th St S Ste 106, Sartell, MN 56377 2011-11-16
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356458475 Mobile Imaging Services, LLC Radiology 2000 Abbott Nw Ct, Ste 115, Sartell, MN 56377 2006-08-24
1700831690 Karla Gay Myhra-bloom Radiology 709 17th St N, Sartell, MN 56377 2006-05-23
1649258526 Michael James Cumming Radiology 1990 Connecticut Ave S Ste 100, Sartell, MN 56377-2554 2006-01-03
1306846076 Jody Allison Bolton Smith Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2005-07-26
1780684639 John Gregory Dalle Radiology 166 19th Street South, Suite 100, Sartell, MN 56377-2154 2005-07-21
1023351533 Shannon Nord Radiology 1990 Connecticut Ave S Ste 100, Sartell, MN 56377-2554 2013-04-03
1104192541 James Dickinson Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2012-03-30
1487965109 Scott Klettke Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2010-06-28
1598085268 Britton Joseph Carter Radiology 166 19th Street South, Suite 100, Sartell, MN 56377-2154 2010-06-04
1487819751 Francis X. Kigozi Radiology 1990 Connecticut Ave S, Sartell, MN 56377-2554 2008-07-25
Find all providers in SARTELL

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City SARTELL
Zip Code 56377

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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