SHASTRI BOOTHE (NPI# 1235177569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235177569 |
| Entity Type | Individual |
| Full Name | SHASTRI BOOTHE |
| Credential | PA |
| Practice Address |
18161 W 13 Mile Rd Suite A-2 Southfield MI 48076-1113 |
| Practice Telephone | 2486429893 |
| Mailing Telephone | 2486429893 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601004456 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
18161 W 13 MILE RD SUITE A-2 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48076-1113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255321287 | Lawrence C Sweet | Allergy & Immunology | 18161 W 13 Mile Rd, Suite C, Southfield, MI 48076-1113 | 2005-10-21 |
| 1023662236 | Amy Michelle Bakalar | Nurse Practitioner | 18161 W 13 Mile Rd, Southfield, MI 48076-1113 | 2019-07-25 |
| 1033588082 | Total Recovery Physical Therapy LLC | Specialist | 18161 W 13 Mile Rd, Suite E 3, Southfield, MI 48076-1113 | 2015-09-21 |
| 1164829479 | Ocie Drake Jr. | Dentist | 18161 W 13 Mile Rd, Suite D-1, Southfield, MI 48076-1113 | 2014-12-02 |
| 1639573389 | Biochem Diagnostics Laboratory, Inc | Clinical Medical Laboratory | 18161 W 13 Mile Rd, Suite D3, Southfield, MI 48076-1113 | 2014-10-09 |
| 1215276092 | Dathatreya Kandagari | Physical Therapist | 18161 W 13 Mile Rd, Suite E-3, Southfield, MI 48076-1113 | 2013-02-13 |
| 1295088870 | Total Recovery Physical Therapy | Physical Therapy Assistant | 18161 W 13 Mile Rd, Suite E3, Southfield, MI 48076-1113 | 2012-10-19 |
| 1386935955 | Kathy Lynn Bashawaty | Nurse Practitioner | 18161 W 13 Mile Rd, Suite E1, Southfield, MI 48076-1113 | 2011-04-29 |
| 1144536954 | Bronco Injury & Chiropractic Center, Inc. | Chiropractor | 18161 W 13 Mile Rd, Ste E3, Southfield, MI 48076-1113 | 2010-08-31 |
| 1508195835 | Michigan Diagnostic, LLC | Specialist/Technologist, Other | 18161 W 13 Mile Rd, Suite E3, Southfield, MI 48076-1113 | 2009-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813753 | Elaine Sarah Kahn | Social Worker | 15999 West Twelve Mile Rd, Southfield, MI 48076 | 2020-08-31 |
| 1295353829 | Marian Hannah Ibrahim | Dentist | 19189 W 12 Mile Rd, Lathrup Village, MI 48076 | 2020-07-09 |
| 1699317669 | Meadow Lane Rehabilitative Therapies LLC | Social Worker | 29895 Greenfield Rd., Suite 104b, Southfield, MI 48076 | 2019-10-11 |
| 1760035752 | Taliah Laneice Williams-hunter | Counselor | 30119 Sparkleberry Dr., Southfield, MI 48076 | 2019-07-19 |
| 1386114742 | Mavis Gail Pookrum | Technician | 21732 Colony Park Circle #105, Southfield, MI 48076 | 2018-11-28 |
| 1861962417 | Millennial Infusion Centers Inc | Clinic/Center | 26250 Northwestern Hwy Ste 201, Southfield, MI 48076 | 2018-11-27 |
| 1215429212 | Debra Deanes | Counselor | 30233 Southfiels Rd, 203, Southfield, MI 48076 | 2018-06-05 |
| 1437675758 | Kenneth Gerard Giles | Counselor | 29532 Southfield Rd. Suite 208, Southfield, MI 48076 | 2017-08-17 |
| 1902346836 | Linsk Psychiatry Services P C | Clinic/Center | 21751 W 12 Mile Rd, Suite 205, Southfield, MI 48076 | 2017-02-25 |
| 1023552361 | Massage Serenity | Community/Behavioral Health | 20245 W. 12 Mile Rd, Suite 113, Southfield, MI 48076 | 2016-12-06 |
| Find all providers in zip 48076 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231252 | Kaitlin Elizabeth Flaherty | Physician Assistant | 30130 Northgate Ln, Southfield, MI 48076-1063 | 2020-07-02 |
| 1265090047 | Kathy Thi Y Nhi Pham | Physician Assistant | 29689 Marshall St, Southfield, MI 48076-5845 | 2019-06-05 |
| 1013488535 | Rachel Moss | Physician Assistant | 26400 W 12 Mile Rd Ste 170, Southfield, MI 48034-1753 | 2018-12-10 |
| 1760853147 | Reema Sutariya | Physician Assistant | 24901 Northwestern Hwy Ste 214, Southfield, MI 48075-2205 | 2015-10-12 |
| 1760861983 | Erin Anne Hartsmith | Physician Assistant | 29169 Southfield Rd, Southfield, MI 48076 | 2015-05-20 |
| 1871921171 | Megann Jobson | Physician Assistant | 21700 Northwestern Hwy Ste 600, Southfield, MI 48075-4912 | 2013-10-23 |
| 1376970905 | Justin Scott Remsing | Physician Assistant | 28405 Brooks Ln, Southfield, MI 48034-2090 | 2013-09-27 |
| 1396004974 | Winona Chatman Smith | Physician Assistant | 19050 Coral Gables St, Southfield, MI 48076-4431 | 2012-05-16 |
| 1457485237 | Thelma Howard | Physician Assistant | 4000 Town Center, Suite 370, Southfield, MI 48075 | 2007-03-15 |
| 1740367036 | Kristi A Tesarz | Physician Assistant | 26206 W 12 Mile Rd Ste 202, Southfield, MI 48034-8500 | 2006-11-01 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48076 |
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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.