JOHN P BOOTHE


Address: 486 West 1st Ave, Glenns Ferry, ID 83623
Phone: 2083667416

JOHN P BOOTHE (NPI# 1396875720) 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) 1396875720
Entity Type Individual
Full Name JOHN P BOOTHE
Credential PA-C
Practice Address 486 West 1st Ave
Glenns Ferry
ID 83623
Mailing Address Po Box 266
Glenns Ferry
ID 83623-0266
Practice Telephone 2083667416
Practice Fax Number 2083662595
Mailing Telephone 2083667416
Mailing Fax Number 2083662595
Enumeration Date 2007-03-06
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
RPA-101 ID Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
ID DEA # MB0630029 01
ID BLUE CROSS OF IDAHO # PATZ9 01
ID BLUESHIELD OF IDAHO GF# 000010017320 01
ID IDAHO MEDICAL LICENSE # RPA-101 01
ID IDAHO CONTROLLED SUBSTA # CS8825 01

Office Location

Street Address 486 WEST 1ST AVE
City GLENNS FERRY
State ID
Zip Code 83623

Providers in the same location

NPI Name Taxonomy Address Enumeration
1902936362 Malya Bingham Counselor 486 West 1st Ave, Glenns Ferry, ID 83623-0266 2007-03-06

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598263394 Frances Hammons Non-emergency Medical Transport (VAN) 60 East 2nd Ave, Glenns Ferry, ID 83623 2018-01-26
1205348356 Tnt Apothecary LLC Pharmacy 30 Idaho Ave, Glenns Ferry, ID 83623 2017-10-30
1629114939 County of Elmor Consolidated Class A 192 Local Education Agency (LEA) 800 Old Hwy 30, Glenns Ferry, ID 83623 2007-01-30
1851604763 Glenns Ferry Health Center, Inc. Counselor 486 West First Avenue, Glenns Ferry, ID 83623-0266 2010-07-20
1962654673 Rachelle Alice Jaramillo Physician Assistant 486 W First St, Glenns Ferry, ID 83623-0266 2008-10-14
1871607523 Mark Randall Ensminger Family Medicine 486 W First Ave, Glenns Ferry, ID 83623-0266 2006-08-19
1649441627 John C Welch General Practice 486 W 1st Ave, Glenns Ferry, ID 83623-0266 2008-03-18
1376673137 Glenns Ferry Health Center, Inc. Clinic/Center 486 W 1st Ave, Glenns Ferry, ID 83623-2701 2007-03-07
1649828229 Anson Call Dpt Inc Clinic/Center 486 W 1st Ave, Glenns Ferry, ID 83623-2701 2019-08-28
1508339672 Ridley's Family Markets Inc Pharmacy 486 W 1st Ave, Glenns Ferry, ID 83623-2701 2019-01-10
Find all providers in zip 83623

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962654673 Rachelle Alice Jaramillo Physician Assistant 486 W First St, Glenns Ferry, ID 83623-0266 2008-10-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1689217911 David Jeffrey Hanson Physician Assistant 740 Mckinley Ave Ste 100, Kellogg, ID 83837-2693 2019-10-18
1871060681 Travis Henman Physician Assistant 1404 Pomerelle Ave Ste 150, Burley, ID 83318-2012 2018-10-30
1952889685 Cody Mattingly Physician Assistant 14601 S Pleasant Valley Rd, Kuna, ID 83634-2728 2018-08-03
1992174072 Alexa Rhea Physician Assistant 2841 Juniper Dr Ste 2, Lewiston, ID 83501-4719 2015-09-18
1043689441 Derek R Wynn Physician Assistant 607 W Main Street, Grangeville, ID 83530 2015-09-16
1407223274 Michael Kenneth Wucinich Physician Assistant 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301-5823 2015-08-28
1811364177 Ashley Laren Popadics Physician Assistant 1510 12th Ave Rd Ste 200, Nampa, ID 83686-6008 2015-08-21
1073915963 Jessica Bishop Physician Assistant 1499 W Hays St, Boise, ID 83702-5029 2014-09-23
1447652813 Jessea Camille Whitlow Physician Assistant 2392 Addison Ave E, Twin Falls, ID 83301-6745 2014-09-17
1508287061 Heather N Fox Physician Assistant 12273 West Mcmillan Road, Boise, ID 83713 2013-12-30
Find all providers with the same taxonomy

Competitor

Search similar providers

City GLENNS FERRY
Zip Code 83623

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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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