John David Botero, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN207415 Issued in GA

Practice address

631 Professional Dr Ste 450
Lawrenceville, GA 30046-3370

Phone

(770) 963-8030

Fax

(770) 339-9577

NPI assigned

Sep 9, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

70.94

Improvement activities

40

Cost

92.94

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbotero2014038@direct.trinity-health.org

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.

• Cep America LLC

  dba Vituity

  • Emergency Medicine Physician
  • Lithonia, GA
  • NPI 1124073721
  Medicare reassignment NPD
• Gwinnett Emergency Specialists Observation Services, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1720373129
  Medicare reassignment NPD
• Gwinnett Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1437346467
  Medicare reassignment NPD
• Hartwell Emergency Physicians LLC

  • Emergency Medicine Physician
  • Hartwell, GA
  • NPI 1962540849
  Medicare reassignment NPD
• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Putney Memorial Hosptial

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of Georgia PC

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1447784988

  GA

  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Lavonia, GA
  • NPI 1740039262
  NPD
• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Specialty Pharmacy

  • Community/Retail Pharmacy
  • Albany, GA
  • NPI 1891315420
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Houston Emergency Physicians LLC

  • Emergency Medicine Physician
  • Warner Robins, GA
  • NPI 1558319947
  NPD (past)

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1083921274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 450",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "770-963-8030",
            "fax_number": "770-339-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 450",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "770-963-8030",
            "fax_number": "770-339-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTERO",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN207415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boostcare LLC
• Jacqueline Boreland, RN
• Ashley Attaway Born
• Angela Bostic-Maddox
• Scott G Boswell
• Manuela Botero
• James L Bouchard, DPM
• Angel Brown Boulware, FNP-C
• Renee Bouy, CCC-SLP
• Antonette Patrice Bowen, RBT

• Family Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.