BRADLEY DAVID BOOTHE (NPI# 1275032914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275032914 |
| Entity Type | Individual |
| Full Name | BRADLEY DAVID BOOTHE |
| Credential | CNP |
| Practice Address |
10 Southmoor Cir Nw Kettering OH 45429-2444 |
| Mailing Address |
1661 Owens Rd Pleasant Hill OH 45359-8773 |
| Practice Telephone | 9372941489 |
| Practice Fax Number | 9372976468 |
| Mailing Telephone | 9373084574 |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2018-02-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN.CNP.022278 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0265013 | 05 |
| Street Address |
10 SOUTHMOOR CIR NW |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-2444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255330676 | Edward Cornelious Jacobs | Specialist | 10 Southmoor Cir Nw, Kettering, OH 45429-2486 | 2005-07-18 |
| 1285147827 | Tiarah Alisha Todd | Nurse Practitioner | 10 Southmoor Cir Nw, Kettering, OH 45429-2444 | 2017-11-06 |
| 1306128608 | Alliance Physicians Inc | Urology | 10 Southmoor Cir Nw, Kettering, OH 45429-2486 | 2011-09-13 |
| 1811022619 | South Dayton Urological Associates | Urology | 10 Southmoor Cir Nw, Kettering, OH 45429-2444 | 2007-02-22 |
| 1891876470 | Safwat K. Zaki | Urology | 10 Southmoor Cir Nw, Kettering, OH 45429-2444 | 2006-10-18 |
| 1346321965 | Sammy A. Hamway | Urology | 10 Southmoor Cir Nw, Kettering, OH 45429-2444 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740500016 | Cheryl Dunlap Cnp LLC | Nurse Practitioner | 2267 Yorkshire Pl, Kettering, OH 45419-2833 | 2010-06-09 |
| 1912520719 | Rachel French Hunter | Nurse Practitioner | 2115 E Dorothy Ln, Kettering, OH 45420-1176 | 2020-05-27 |
| 1558900431 | Cristina Michelle Murphy | Nurse Practitioner | 2115 E Dorothy Ln, Kettering, OH 45420-1176 | 2019-12-25 |
| 1184265324 | Gretta Weindorf | Nurse Practitioner | 1362 E Stroop Rd, Kettering, OH 45429-4926 | 2019-09-30 |
| 1093375750 | Erika Vanwyck Thomas | Nurse Practitioner | 2115 E Dorothy Ln, Kettering, OH 45420-1176 | 2019-06-15 |
| 1952870594 | Jane Ashley Williamson | Nurse Practitioner | 3700 Southern Blvd, Kettering, OH 45429-1226 | 2018-11-13 |
| 1205325040 | Stephanie Westerbeck | Nurse Practitioner | 3535 Southern Blvd, Kettering, OH 45429 | 2018-05-08 |
| 1487142600 | Wanda Irene Blatter | Nurse Practitioner | 3313 Wilmington Pike, Kettering, OH 45429-4023 | 2018-04-23 |
| 1285147827 | Tiarah Alisha Todd | Nurse Practitioner | 10 Southmoor Cir Nw, Kettering, OH 45429-2444 | 2017-11-06 |
| 1407373392 | Elizabeth Marie Murphy | Nurse Practitioner | 3700 Southern Blvd, Kettering, OH 45429-1226 | 2017-08-23 |
| Find all providers in KETTERING | ||||
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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.