Shane Boosey, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Practice address

400 Pinner Weald Way
Suite 102
Cary, NC 27513-2794

Phone

(919) 428-0885

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 4, 2018 through Feb 4, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Freedom House Recovery Center, Inc.

  • Community/Behavioral Health Agency
  • Chapel Hill, NC
  • NPI 1548490378
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186876800000",
    "number": "1013933399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PINNER WEALD WAY",
            "address_2": "SUITE 102",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275132794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PINNER WEALD WAY",
            "address_2": "SUITE 102",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275132794",
            "telephone_number": "919-428-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOSEY",
        "first_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Boone
• Mary Kaitlyn Boone, M.A.
• Nevaeh Rosalie Boone
• Tamika Boone
• Kaitlin Aynsley Boos, FNP
• Hannah Rae Booth
• William E Booth, PT
• Mark Duncan Bordeaux Jr.
• Rebecca Paige Borg, PA-C
• Sherri Bosely, MA, CCC-SLP

• Psychiatry Physician in Cary, NC
• Providers in Cary, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.