Individual provider Active NPI

Thomas H. Booth II, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Montgomery, AL
National Provider Identifier
1043340912
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-077443 Issued in AL
Practice address
2105 E South Blvd
Montgomery, AL 36116-2409
Phone
(334) 386-3579
NPI assigned
Mar 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1-077443 AL Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC CurrentSince Sep 6, 2023 Accepting new patients
Amsol Anesthetists of Georgia LLC-Hughston Surgical Center Nurse Anesthetist, Certified Registered CurrentSince Aug 21, 2023 Accepting new patients
Amsol Anesthetists of Georgia, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 21, 2023 Accepting new patients
South Baldwin Anesthesia, PC CurrentSince Feb 12, 2015 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

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043340912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235022",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235022",
            "telephone_number": "334-396-6930",
            "fax_number": "334-396-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 E SOUTH BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162409",
            "telephone_number": "334-386-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "THOMAS",
        "middle_name": "H.",
        "name_suffix": "II",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-077443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.