NPIMap

Individual provider Active NPI

Cassie Lee Booth, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Springfield, MO
National Provider Identifier
1154594976
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2016008383 Issued in MO
Practice address
1235 E Cherokee St
Springfield, MO 65804-2203
Phone
(417) 820-2961
NPI assigned
Apr 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 106898 MN
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 56816 MN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2016008383 MO Primary

Addresses

Primary practice location

1235 E Cherokee St
Springfield, MO 65804-2203

Mailing address

PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 829-4620

Other identifiers 3

IdentifierTypeStateIssuer
PENDINGMedicaidOK
PENDINGMedicaidMO
PENDINGMedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160531001616 MO Practitioner - Pathology 3779749890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Loma Linda University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

3817 S Springfield Ave
Sgfmc Bolivar Multi Specialty
Bolivar, MO 65613-9129
Phone (417) 820-3911

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jun 16, 2016 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jun 16, 2016 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 5, 2020 Accepting new patients

Locations

3817 S Springfield Ave
Bolivar, MO 65613
Phone (417) 422-4769

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

Organizations & group practices 3

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1208044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1154594976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505164",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505164",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "CASSIE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-13",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MN",
            "license": "106898",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MN",
            "license": "56816",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2016008383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.