Active NPI
Terra Lynn Bookout, MS, PA-C
- Physician Assistant
- Englewood, CO
National Provider Identifier
1013252642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3458
- Practice address
- 125 Inverness Dr E
Suite 240
Englewood, CO 80112-5137 - Phone
- (720) 863-1004
- NPI assigned
- Dec 8, 2012
- Last updated
- Dec 8, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3458 | CO | Primary |
Addresses
Primary practice location
125 Inverness Dr E
Suite 240
Englewood, CO 80112-5137
Mailing address
2416 Black Duck Ave.
Johnstown, CO 80534
Phone (970) 231-5441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3458 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354924800000",
"number": "1013252642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2416 BLACK DUCK AVE.",
"city": "JOHNSTOWN",
"state": "CO",
"postal_code": "80534",
"telephone_number": "970-231-5441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 INVERNESS DR E",
"address_2": "SUITE 240",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801125137",
"telephone_number": "720-863-1004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOKOUT",
"first_name": "TERRA",
"middle_name": "LYNN",
"credential": "MS, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-08",
"last_updated": "2012-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "3458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Englewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.