Shataesia S Booker, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-14085 Issued in NC

Practice address

1728 Fordham Blvd Ste 151
Chapel Hill, NC 27514-2332

Phone

(910) 429-0647

NPI assigned

Mar 18, 2024

Last updated

Jun 11, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mainstreet and Kidsstreet of North Carolina PLLCGroup PAC ID 6901290238, 76 clinicians

American Current Care of North Carolina PCGroup PAC ID 8426196098, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Locust, NC
  • NPI 1144803040
  Medicare reassignment Care Compare group NPD
• American Current Care of North Carolina, P.C.

  • Health Service Clinic/Center
  • Addison, TX
  • NPI 1306015102

  NC

  Medicare reassignment Care Compare group NPD
• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Burlington, NC
  • NPI 1043170558
  NPD
• Hope Mills Urgent Care & Medical Clinic, PLLC

  • Internal Medicine Physician
  • Hope Mills, NC
  • NPI 1114134293
  NPD (past)

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1114786795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 ECCLES LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276169580",
            "telephone_number": "864-380-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 FORDHAM BLVD STE 151",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142332",
            "telephone_number": "910-429-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "SHATAESIA",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan William Bonner
• Michael Francis Bonnett, PMHNP-BC
• John Bonney, ATC
• Johanna M Boobas
• Jessica Karen Booker, PHD
• Christine Elizabeth Bookhout, MD
• Lynne C Bookhout, M.D.
• Claire Elise Books, MD, MPH
• Natalie Boorman, LCSW
• Cynthia L Boortz-Marx, CRNA

• Physician Assistant in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.