Individual provider Active NPI

Katherine Elizabeth Booth, FNP-C

  • Family Nurse Practitioner
  • Destin, FL
National Provider Identifier
1194618686
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11038870 Issued in FL
Practice address
90 Country Club Dr W
Destin, FL 32541-4406
Phone
(651) 707-4237
NPI assigned
Jun 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11038870 FL Primary

Addresses

Primary practice location

90 Country Club Dr W
Destin, FL 32541-4406

Mailing address

90 Country Club Dr W
Destin, FL 32541-4406
Phone (651) 707-4237

Other names 1

  • Katherine Elizabeth Benson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20251220000294 FL Practitioner - Nurse Practitioner 1850886425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Anesthesia, P aGroup PAC ID 5890727036, 2 clinicians

Practice addresses (Care Compare)

1001 College Blvd W
Suite H
Niceville, FL 32578-1049
Phone (850) 279-4417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11038870FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Anesthesia, P a CurrentSince Dec 2, 2025 Accepting new patients

Locations

1001 College Blvd W
Ste H
Niceville, FL 32578
Phone (850) 279-4417

2190 Highway 85 N
Niceville, FL 32578
Phone (850) 678-4131

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1194618686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 COUNTRY CLUB DR W",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325414406",
            "telephone_number": "651-707-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 COUNTRY CLUB DR W",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325414406",
            "telephone_number": "651-707-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11038870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "BENSON",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Destin, FL

Sources for this page

Verify at the official NPI Registry.