OLESSYA BOLOTOV (NPI# 1134670136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134670136 |
| Entity Type | Individual |
| Full Name | OLESSYA BOLOTOV |
| Credential | NP-C |
| Practice Address |
50 N Perry St Fadi Salloum, Md, PC Pontiac MI 48342-2217 |
| Practice Telephone | 2483385516 |
| Practice Fax Number | 2483385547 |
| Mailing Telephone | 2483385516 |
| Mailing Fax Number | 2483385547 |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
4704284965 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
50 N PERRY ST FADI SALLOUM, MD, PC |
| City | PONTIAC |
| State | MI |
| Zip Code | 48342-2217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003890856 | Matthew Swayze | Emergency Medicine | 50 N Perry St, Pontiac, MI 48342-2217 | 2005-12-05 |
| 1962000539 | Belinda Becker | Nurse Practitioner | 50 N Perry St, Pontiac, MI 48342-2217 | 2020-10-15 |
| 1336765486 | Mikita Patel | Student in an Organized Health Care Education/Training Program | 50 N Perry St, Pontiac, MI 48342-2217 | 2020-06-24 |
| 1306461264 | Brandon Knight | Student in an Organized Health Care Education/Training Program | 50 N Perry St, Pontiac, MI 48342-2217 | 2020-06-16 |
| 1295350122 | Stephanie Schwartz | Student in an Organized Health Care Education/Training Program | 50 N Perry St, Pontiac, MI 48342-2217 | 2020-06-16 |
| 1437774833 | Cailyn D'haem | Student in an Organized Health Care Education/Training Program | 50 N Perry St, Pontiac, MI 48342-2217 | 2020-06-11 |
| 1790300358 | Sara F Iqbal | Student in an Organized Health Care Education/Training Program | 50 N Perry St, Pontiac, MI 48342-2217 | 2020-06-10 |
| 1053936617 | Bodrie J Jensen | Student in an Organized Health Care Education/Training Program | 50 N Perry St, Pontiac, MI 48342-2217 | 2020-06-10 |
| 1033734694 | Neal R Krentz | Student in an Organized Health Care Education/Training Program | 50 N Perry St, Pontiac, MI 48342-2217 | 2020-06-10 |
| 1154946713 | Gurkirat Jawanda | Student in an Organized Health Care Education/Training Program | 50 N Perry St, Pontiac, MI 48342-2217 | 2020-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528589561 | Beloved Home Care LLC. | Home Health | 12 S Mill. St., Apt.314, Pontiac, MI 48342 | 2017-06-29 |
| 1518496942 | Boris Tkach | Student in an Organized Health Care Education/Training Program | 50 N. Perry, Pontiac, MI 48342 | 2017-06-08 |
| 1023547429 | Nicholas James Stepanski | Student in an Organized Health Care Education/Training Program | 50 N. Perry St., Pontiac, MI 48342 | 2017-06-08 |
| 1245769991 | Mecca House Corporation | Assisted Living Facility | 53 West Huron, Pontiac, MI 48342 | 2017-06-07 |
| 1134672868 | Shannon Blaine | Technician, Other | 103 Parkhurst Street, Pontiac, MI 48342 | 2016-07-29 |
| 1669819249 | Bonnie Ann Smith | Occupational Therapist | 60 Parkhurst Dr., Pontiac, MI 48342 | 2013-05-23 |
| 1205123361 | Mary Ellen Kenworthy | Emergency Medicine | 50 North Perry Street, Pontiac, MI 48342 | 2011-07-08 |
| 1740516343 | Nathima Habib Atchoo | Obstetrics & Gynecology | 90 West University, Gary Burnstein Community Health Clinic (free Clinic), Pontiac, MI 48342 | 2009-11-02 |
| 1881824233 | Sylvia Lyn Thompson | Physical Therapist | 900 Auburn Road, Pontiac, MI 48342 | 2009-07-20 |
| 1114154150 | Kyannah Toyann Anderson | Home Health | 175 S.edith St, Pontiac, MI 48342 | 2009-06-17 |
| Find all providers in zip 48342 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083106140 | Carly Lynn Kassa | Nurse Practitioner | 50 N Perry St, Pontiac, MI 48342-2217 | 2018-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942800768 | Yuri L Guzman | Nurse Practitioner | 795 N Ford Blvd, Ypsilanti, MI 48198-4116 | 2020-10-30 |
| 1144830803 | Robert Eugene Scribner IIi | Nurse Practitioner | 13913 Toepfer Rd, Warren, MI 48089-5842 | 2020-08-06 |
| 1124644661 | Denika Leflora Dalton | Nurse Practitioner | 5260 Fairway Trl, Grand Blanc, MI 48439-9445 | 2020-06-21 |
| 1780206995 | Jennifer Kay Marino | Nurse Practitioner | 20407 Mauer St, Saint Clair Shores, MI 48080-3789 | 2020-05-11 |
| 1720621709 | Kelsey Nicole Kloosterman | Nurse Practitioner | Susan P. Wheatlake Regional Cancer Center, 4499 220th Ave, Reed City, MI 49677 | 2019-10-23 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1306318498 | Ashley Marie Jacobson | Nurse Practitioner | 4100 Lake Dr Se Ste D, Grand Rapids, MI 49546-8292 | 2018-12-30 |
| 1568931673 | Jennifer Lavigne | Nurse Practitioner | 145 Michigan St Ne Ste 3300, Grand Rapids, MI 49503-2562 | 2018-11-19 |
| 1134694292 | Sheryl Ann Newton | Nurse Practitioner | 810 W South St, Kalamazoo, MI 49007-4601 | 2018-10-04 |
| 1386123180 | Alison M Sesock | Nurse Practitioner | 5202 Miller Rd Ste B, Flint, MI 48507-1040 | 2018-08-13 |
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| 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.