Rachael Booth

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

834258 Issued in TX

Practice address

6104 Avenue Q South Dr
Lubbock, TX 79412-3700

Phone

(806) 472-3474

NPI assigned

Sep 24, 2014

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 names 1

• Rachael Marie Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1124420963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6104 AVENUE Q SOUTH DR",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794123700",
            "telephone_number": "806-472-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6104 AVENUE Q SOUTH DR",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794123700",
            "telephone_number": "806-472-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "RACHAEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "7944289-3102",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "TX",
            "license": "834258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHAEL",
            "last_name": "CLARK",
            "middle_name": "MARIE",
            "credential": "RN, BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy Lewis Boomer, PA-C
• Amy M Boone, SLP-ASSISTANT
• Stacy Boone, P.A.
• Boonipat Craniofacial and Facial Plastic Surgery (Boonipat Facial Plastic Surgery)
• James Jeffrey Boop, M.D.
• Kandis Wright Boothe, MD, PHD
• William David Boothe, M.D.
• William David Boothe Jr., M.D.
• Frances Greg Y Bordon, ACNP
• Anne Renee Borges, LPC

• Ambulatory Care Registered Nurse in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Ambulatory Care Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.