KARA M BOOTH


Address: 35 Executive Dr, Suite 5, Lafayette, IN 47905-3835
Phone: 7654468300

KARA M BOOTH (NPI# 1619419124) 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) 1619419124
Entity Type Individual
Full Name KARA M BOOTH
Other Name KARA M RICKETTS
Credential RD
Practice Address 35 Executive Dr
Suite 5
Lafayette
IN 47905-3835
Mailing Address 120 Heron Ct
West Lafayette
IN 47906-5088
Practice Telephone 7654468300
Mailing Telephone 8125991240
Enumeration Date 2016-11-15
Last Update Date 2016-11-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 133V00000X Dietitian, Registered Dietary & Nutritional Service Providers
Y 133VN1004X Dietitian, Registered
Specialization: Nutrition, Pediatric
Dietary & Nutritional Service Providers

Office Location

Street Address 35 EXECUTIVE DR
SUITE 5
City LAFAYETTE
State IN
Zip Code 47905-3835

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NPI Name Taxonomy Address Enumeration
1750999884 Kayla Sis Physical Therapist 35 Executive Dr, Lafayette, IN 47905-3835 2020-07-15

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NPI Name Taxonomy Address Enumeration
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1255750899 Emily S Miller Physical Therapist 1701 Creasy Ln, Lafayette, IN 47905 2014-04-10
1073876215 Nathan Webster Dentist 1530 Kossuth St., Lafayette, IN 47905 2012-06-22
1578848370 Mark Jin Kim Pharmacist 1801 South St., Lafayette, IN 47905 2011-10-13
1700177185 Shannon Tawn Harris Speech-Language Pathologist 8900 Cobbler Lane, Lafayette, IN 47905 2011-04-20
1508164484 David Thomas Beine Specialist/Technologist 1321 Unity Pl Ste A, Lafayette, IN 47905 2011-03-02
1447569538 Deidre Dudley Nurse Practitioner 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 2010-10-07
1548493067 Unity Healthcare, LLC Podiatrist 750 Park East Blvd, Unit 4, Lafayette, IN 47905 2009-09-01
1073762969 Lynette Marie Alexander Nurse Practitioner 5500 St Rd. 38 East, Lafayette, IN 47905 2008-09-16
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Taxonomy Information

Taxonomy Code 133VN1004X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered
Specialization Nutrition, Pediatric

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1194052365 Hazel Irene Lewis Dietitian, Registered 1125 Logan Ave, Lafayette, IN 47905-1829 2009-11-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1093094575 Elizabeth Ann Brine Dietitian, Registered 3237 W County Road 875 S, Reelsville, IN 46171-9477 2011-08-15
1598094781 Mary Beth Becht Dietitian, Registered 3155 Jason St, Carmel, IN 46033-8765 2009-12-16
1447589080 Lisa Suzanne Flanders Dietitian, Registered 14847 Strawtown Ave, Noblesville, IN 46060-6974 2009-12-10
1255591590 Dawn Marie Fulmer Dietitian, Registered 1201 Bower St, Elkhart, IN 46514-2434 2008-06-10
1588838833 Judy Anne Busch Dietitian, Registered 10210 N Delaware St, Indianapolis, IN 46280-1348 2008-04-17
1184847378 Regina S Isroff Dietitian, Registered 2202 Cherokee Cir, Valparaiso, IN 46383-2284 2007-04-10
1962523597 Sheri Lynn Glaze Dietitian, Registered 1644 Rudgate Dr, Avon, IN 46123-8408 2007-04-02
1134738677 Jenna Pogorzelski Dietitian, Registered 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 2020-07-30
1083240626 Abigail Nicole Demlow Dietitian, Registered 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 2020-03-16
1083101547 Lea Michelle Seals Dietitian, Registered 518 Main St, Brookville, IN 47012-1408 2018-04-19
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Competitor

Search similar providers

City LAFAYETTE
Zip Code 47905

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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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