Thomas H. Booth II, C.R.N.A.
Individual provider Active NPI Certified Registered Nurse Anesthetist · Montgomery, AL
NPI 1043340912 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043340912
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 1-077443 (AL)
- Practice address
- 2105 E South Blvd
Montgomery, AL 36116-2409 - Phone
- (334) 386-3579
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AL, GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060314000270 | AL | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9931116167 | Reassigns benefits to 2 organizations |
| I20231004001127 | GA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9931116167 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-077443 | AL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Baldwin Anesthesia, PC | Current |
Accepting new patients | |
| Amsol Anesthetists of Georgia, LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Amsol Anesthetists of Georgia LLC-Hughston Surgical Center | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Sentry Anesthesia Management, LLC | Current |
Accepting new patients | |
| Premier Anesthesia of Montgomery PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
1613 N McKenzie St
Foley, AL 36535
Phone (251) 949-3400
4401 Riverchase Dr
Phenix City, AL 36867
Phone (334) 732-3000
13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784
126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011
1755 Highway 34 E
Newnan, GA 30265
Phone (770) 254-6040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1-077443 | AL | Yes |
Addresses
Primary practice location
2105 E South Blvd
Montgomery, AL 36116-2409
Mailing address
PO Box 235022
Montgomery, AL 36123-5022
Phone (334) 396-6930
Other providers in Montgomery, AL
- Julie Anne Bond
- Leanne M Bond
- Cynthia M Bonner
- Johnny Lee Bonner
- Naga Vijaya Lakshmi Divya Boorle
- George Austin Boothe
- Karlene R Boozer
- Brittany Leshell Borders
- Stephen J. Bordlee
- Gregory Borg
All providers in Montgomery, AL · Certified Registered Nurse Anesthetist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.