Holly Renee Booth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1673DT Issued in KY

Practice address

1502 Cumberland Ave
Middlesboro, KY 40965-1223

Phone

(606) 248-0932

Fax

(606) 248-1384

NPI assigned

Jul 27, 2006

Last updated

Jul 16, 2016By 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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in KY, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Elite Vision Center LLCGroup PAC ID 8628238995, 2 clinicians

William F. Metzger, PSCGroup PAC ID 7911923800, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.88 of 100Reported as group

Quality

83.87

Promoting interoperability

100

Improvement activities

40

Cost

76.45

Merit-based Incentive Payment System (MIPS)

Final score

96.51 of 100Reported as group

Quality

75.46

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Elite Vision Center LLC

  • Optometrist
  • Middlesboro, KY
  • NPI 1295008803
  Medicare reassignment Care Compare group NPD
• William F. Metzger, PSC

  • Optometrist
  • Ft Wright, KY
  • NPI 1174657993
  Medicare reassignment Care Compare group NPD
• Jessup Mobile Opt TN LLC

  • Optometrist
  • Nashville, TN
  • NPI 1740763325
  Medicare reassignment NPD
• David G. Sanford, M.D., P.S.C.

  • Ophthalmology Physician
  • New Tazewell, TN
  • NPI 1558033167
  NPD
• Southeast Eye Associates, PLLC

  • Optometrist
  • Middlesboro, KY
  • NPI 1104952928
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468627200000",
    "number": "1194749473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 CUMBERLAND AVE",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651223",
            "telephone_number": "606-248-0932",
            "fax_number": "606-248-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 CUMBERLAND AVE",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651223",
            "telephone_number": "606-248-0932",
            "fax_number": "606-248-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "HOLLY",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1673DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010332605",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA PROVIDER NUMBER",
            "identifier": "1231987",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN NUMBER",
            "identifier": "000000492097",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "1673DT",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION CARE PIN NUMBER",
            "identifier": "134506",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bell Emergency Group, LLC
• Blue Mountain Medical Clinic, PLLC
• Bluegrass Adult Care, LLC
• Charles Bruce Boggs II, PHARM.D.
• Alyssa Boldin, NP
• Joseph McKinley Boster, D.M.D.
• Bowkirk Medical (Peoples Choice Pharmacy)
• Taylor Bowling, OT
• Bright Future Primary Care
• Bright Future Primary Care, Inc.

• Optometrist in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2016; 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.