Individual provider Active NPI

Katelyn Jean Booher, D.O.

  • Infectious Disease Physician
  • Dayton, OH
National Provider Identifier
1063736056
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
35-011518 Issued in OH
Practice address
1222 S Patterson Blvd
Ste 220
Dayton, OH 45402-2684
Phone
(937) 223-5350
Fax
(937) 224-3112
NPI assigned
Mar 18, 2010
Last updated
Jun 29, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Infectious Disease Physician 207RI0200X 35-011518 OH Primary
Internal Medicine Physician 207R00000X 35-011518 OH

Addresses

Primary practice location

1222 S Patterson Blvd
Ste 220
Dayton, OH 45402-2684

Mailing address

725 University Blvd
Dayton, OH 45435-0001
Phone (937) 245-7100

Other identifiers 1

IdentifierTypeStateIssuer
0121909MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831000256 OH Practitioner - Infectious DiseasePractitioner - Internal Medicine 4880822881 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Five Rivers Health CentersGroup PAC ID 9335300904, 45 clinicians
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

2261 Philadelphia Dr
Dayton, OH 45406-1814
Phone (937) 281-6800

30 E Apple St
Suite 6221
Dayton, OH 45409-2939
Phone (937) 208-6630

721 Miami Chapel Rd
Dayton, OH 45417-4650
Phone (937) 281-6800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.17 of 100Reported as group
Quality
65.6
Promoting interoperability
100
Improvement activities
40
Cost
74.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
35-011518OHMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Health Centers Current Accepting new patients
Five Rivers Health Centers CurrentSince Jan 7, 2017 Accepting new patients
Premier Health Specialists Inc Internal Medicine CurrentSince Nov 1, 2024 Accepting new patients
Five Rivers Health Centers CurrentSince Jan 7, 2017 Accepting new patients
Premier Health Specialists Inc CurrentSince Nov 1, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Wright State Physicians Inc Past Accepting new patients

Locations

2261 Philadelphia Dr
Dayton, OH 45406
Phone (937) 281-6800

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

30 E Apple St
Ste 6221
Dayton, OH 45409
Phone (937) 208-6630

30 E Apple St
Ste 6258
Dayton, OH 45409
Phone (937) 208-5055

721 Miami Chapel Rd
Dayton, OH 45417
Phone (937) 281-5970

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1063736056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 UNIVERSITY BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350001",
            "telephone_number": "937-245-7100",
            "fax_number": "937-245-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "STE 220",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-223-5350",
            "fax_number": "937-224-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOHER",
        "first_name": "KATELYN",
        "middle_name": "JEAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-18",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OH",
            "license": "35-011518",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-011518",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0121909",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.