NPIMap

Individual provider Active NPI

Joshua Booth, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, MI
National Provider Identifier
1003446006
Registry record updated Jan 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704276659 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-4800
NPI assigned
Jan 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704276659 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

16206 Wetherby St
Beverly Hills, MI 48025-5559
Phone (248) 550-2279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200413003143 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294165304 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians
Long Lake Anesthesiology Consultants PLCGroup PAC ID 7113818980, 94 clinicians

Practice addresses (Care Compare)

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (214) 687-0001

4550 Investment Dr
Troy, MI 48098-6334
Phone (248) 265-4600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Environ Anesthesia, LLC. Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
Novi Aas LLC CurrentSince Sep 20, 2020 Accepting new patients
Wa Foote Memorial Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 7, 2020 Accepting new patients
Long Lake Anesthesiology Consultants, PLC CurrentSince Jun 1, 2025 Accepting new patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Dec 2, 2021 Accepting new patients
Henry Ford West Bloomfield Hospital Nurse Anesthetist, Certified Registered CurrentSince Feb 28, 2022 Accepting new patients
Henry Ford Health System CurrentSince Dec 2, 2021 Accepting new patients
Henry Ford West Bloomfield Hospital CurrentSince Feb 28, 2022 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince May 10, 2022 Accepting new patients
Michigan Crnas Staffing LLC CurrentSince Sep 20, 2020 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Mar 7, 2020 Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

949 National Ave
Ste 151
Lexington, KY 40502
Phone (859) 509-8399

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

205 S East Ave
Jackson, MI 49201
Phone (517) 205-2103

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220

920 River Centre Dr
Port Huron, MI 48060
Phone (810) 984-5200

326 N Main St
Royal Oak, MI 48067
Phone (248) 584-7600

3601 W 13 Mile Rd
Royal Oak, MI 48073

4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: jbooth372847@direct.hfhs.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579392000000",
    "number": "1003446006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16206 WETHERBY ST",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255559",
            "telephone_number": "248-550-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "JOSHUA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-19",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704276659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.