Kerri Noel Booker, RDH, MMS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA057054 Issued in PA

Practice address

100 N Academy Ave
Danville, PA 17822-2005

Phone

(570) 271-6812

Fax

(570) 271-6507

NPI assigned

Jun 2, 2014

Last updated

Mar 9, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1053723544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178222005",
            "telephone_number": "570-271-6812",
            "fax_number": "570-271-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "KERRI",
        "middle_name": "NOEL",
        "name_prefix": "Ms.",
        "credential": "RDH, MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ID",
            "identifier": "106722",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leonard Phillip Boltinghouse, RPH
• Andrew James Bomar, MD
• Brandon Charles Bombar, MD
• Jamie Marie Bond
• Steven Bonebrake, D.O.
• Larry R. Booker, PA-C
• Tyler Boozel, D.O.
• Evan Bopp
• Corey V. Boren, CRNA
• Ally Teresa Borgia

• Physician Assistant in Danville, PA
• Providers in Danville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.