FRED BOOTHBY (NPI# 1962483271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962483271 |
| Entity Type | Individual |
| Full Name | FRED BOOTHBY |
| Credential | CNP |
| Practice Address |
3285 122nd Ave P.o. Drawer 130 Allegan MI 49010-9511 |
| Practice Telephone | 2696736617 |
| Practice Fax Number | 2696732738 |
| Mailing Telephone | 2696736617 |
| Mailing Fax Number | 2696732738 |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2008-01-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4704142595 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4699274 | 05 | |
| MI | BCBS | 5008704740 | 01 |
| Street Address |
3285 122ND AVE P.O. DRAWER 130 |
| City | ALLEGAN |
| State | MI |
| Zip Code | 49010-9511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548890957 | Jacob Mayle | Behavior Technician | 3285 122nd Ave, Allegan, MI 49010-9511 | 2020-01-24 |
| 1023666096 | Kimberly Renee Bouchard | Emergency Medical Technician, Intermediate | 3285 122nd Ave, Allegan, MI 49010-9511 | 2019-09-03 |
| 1427611672 | Caitlin Bradley | Social Worker | 3285 122nd Ave, Allegan, MI 49010-9511 | 2019-04-15 |
| 1396212676 | Michael Silvasi | Registered Nurse | 3285 122nd Ave, Allegan, MI 49010-9511 | 2018-10-25 |
| 1932685195 | Bree Jenene Austin-roberts | Social Worker | 3285 122nd Ave, Allegan, MI 49010-9511 | 2018-07-11 |
| 1780178301 | Zachary Thomas Lindell | Social Worker | 3285 122nd Ave, Allegan, MI 49010-9511 | 2018-06-18 |
| 1205329018 | Emma Higgs | Social Worker | 3285 122nd Ave, Allegan, MI 49010-9511 | 2018-06-07 |
| 1861991853 | Leigh Ann Austin | Social Worker | 3285 122nd Ave, Allegan, MI 49010-9511 | 2018-02-06 |
| 1841798790 | Nancy L Thibos | Registered Nurse | 3285 122nd Ave, Allegan, MI 49010-9511 | 2018-01-25 |
| 1427564988 | Alison Kay Schuyler | Social Worker | 3285 122nd Ave, Allegan, MI 49010-9511 | 2017-12-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295384832 | Rachel Wychers | Counselor | 329 Water St, Allegan, MI 49010 | 2019-09-06 |
| 1073968277 | Brandy Sue Salters | Social Worker | 631 Highpoint Dr, Apt 12, Allegan, MI 49010 | 2016-04-26 |
| 1306223359 | John Eagle Jr. | Social Worker | 3283 122nd Ave., Allegan, MI 49010 | 2015-04-29 |
| 1780017061 | Pmc Medical Associates, PC | Preventive Medicine | 325 Eastern Avenue, Allegan, MI 49010 | 2013-08-09 |
| 1629303680 | Assisted Residential Services | Behavioral Analyst | 845 Stern St, Allegan, MI 49010 | 2009-10-08 |
| 1710109335 | Christopher Michael Childers | Dietitian, Registered | 555 Linn Street, Allegan, MI 49010 | 2007-05-03 |
| 1205972916 | David Joseph Seifferly | Dentist | 425 Cutler Str, Allegan, MI 49010 | 2007-01-29 |
| 1194780304 | Mona Esse Ruse | Chiropractor | 279 Thomas Street, Allegan, MI 49010 | 2006-04-19 |
| 1316928161 | Timothy Dickinson | Family Medicine | 551 Linn Street, Allegan, MI 49010 | 2005-11-09 |
| 1144720186 | Caitlin Mark | Occupational Therapist | 3265 122nd Ave, Allegan, MI 49010 | 2018-02-16 |
| Find all providers in zip 49010 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912515586 | Rebecca Jo Nielsen | Nurse Practitioner | 530 Linn St, Allegan, MI 49010-1562 | 2020-07-20 |
| 1154674745 | Erin E Beauchamp | Nurse Practitioner | 3285 122nd Ave, Allegan, MI 49010-9511 | 2012-10-19 |
| 1861441115 | Linda S Wadsworth | Nurse Practitioner | 551 Linn St, Suite 150, Allegan, MI 49010-1595 | 2006-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154599 | Kelly Phuong Doan | Nurse Practitioner | 27327 23 Mile Rd, Chesterfield, MI 48051-2045 | 2020-11-04 |
| 1275133217 | Maureen Mae Lewis | Nurse Practitioner | 2782 N Coleman Rd, Coleman, MI 48618-9721 | 2020-10-29 |
| 1073113460 | Taylor L Pichette | Nurse Practitioner | 758 Lucille Dr, Wolverine Lake, MI 48390-2327 | 2020-10-27 |
| 1295333938 | Amanda Covell | Nurse Practitioner | 624 Cherry St Se Apt 5, Grand Rapids, MI 49503-4778 | 2020-10-14 |
| 1689271314 | Nicole Conklin | Nurse Practitioner | 524 Doyle Rd, Laingsburg, MI 48848-9611 | 2020-10-06 |
| 1447857677 | Shelby Lynn Waibel | Nurse Practitioner | 560 W Mitchell St Ste 210, Petoskey, MI 49770-2276 | 2020-10-01 |
| 1497361638 | Amira Aljamal | Nurse Practitioner | 4601 Shenandoah Ave, Allen Park, MI 48101-3131 | 2020-09-22 |
| 1659987014 | Sean Thomas Kane | Nurse Practitioner | 13734 Parallel Ave, Alpena, MI 49707-7987 | 2020-09-21 |
| 1235743592 | Mojica, LLC | Nurse Practitioner | 4163 W Pointe Dr, Waterford, MI 48329-4648 | 2020-09-03 |
| 1942812094 | Meagan James | Nurse Practitioner | 407 E Huron River Dr, Belleville, MI 48111-2763 | 2020-08-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on FRED BOOTHBY.
| 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.