NPIMap

Individual provider Active NPI

David K Booth II, D.O.

  • Family Medicine Physician
  • Greenwood, IN
National Provider Identifier
1144250689
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02004083A Issued in IN
Practice address
3000 S State Road 135 Ste 330
Greenwood, IN 46143-9825
Phone
(317) 497-2400
Fax
(317) 497-2515
NPI assigned
Jul 3, 2006
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS012260 PA
Family Medicine Physician 207Q00000X 02004083A IN Primary

Addresses

Primary practice location

3000 S State Road 135 Ste 330
Greenwood, IN 46143-9825

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890

Other practice location 1

3000 S State Road 135
Suite 310
Greenwood, IN 46143-9825
Phone (317) 497-2400

Other identifiers 3

IdentifierTypeStateIssuer
1018551710001MedicaidPA
201089740MedicaidIN
P01157043OtherINRR MEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dbooth51873@eCommunityDirect.com Community Hospitals of Indiana, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130205000571 IN Practitioner - Family Practice 3072515659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

3000 S State Rd
135 Suite 310
Greenwood, IN 46143-5527
Phone (317) 497-2400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Oct 29, 2012 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Oct 29, 2012 Accepting new patients
Major Hospital Past Accepting new patients
Meadville Medical Center PastSince Aug 3, 2010 Accepting new patients
Meadville Medical Center Past Accepting new patients
Meadville Emergency Phys PC Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

3000 S State Road 135
Ste 310
Greenwood, IN 46143
Phone (317) 497-2400

3000 S State Road 135
Ste 330
Greenwood, IN 46143
Phone (317) 497-2400

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Interoperability endpoints

  • Direct secure messaging: dbooth51873@ecommunitydirect.com

Organizations & group practices 6

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 10

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1144250689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 S STATE ROAD 135 STE 330",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461439825",
            "telephone_number": "317-497-2400",
            "fax_number": "317-497-2515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 S State Road 135",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461439825",
            "country_code": "US",
            "telephone_number": "317-497-2400",
            "fax_number": "317-497-2515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "DAVID",
        "middle_name": "K",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012260",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02004083A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018551710001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201089740",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01157043",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dbooth51873@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Hospitals of Indiana, INC",
            "address_1": "3000 S State Road 135",
            "address_2": "Suite 310",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461439825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.