Individual provider Active NPI

Rebekah Elise Booth, M.D.

  • Pediatrics Physician
  • Corbin, KY
National Provider Identifier
1194997502
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
44547 Issued in KY
Practice address
60 Bryan Blvd
Suite 200
Corbin, KY 40701-2779
Phone
(606) 528-9700
Fax
(606) 528-8423
NPI assigned
Mar 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 44547 KY Primary

Addresses

Primary practice location

60 Bryan Blvd
Suite 200
Corbin, KY 40701-2779

Mailing address

60 Bryan Blvd
Suite 200
Corbin, KY 40701-2779
Phone (606) 528-9700

Other identifiers 1

IdentifierTypeStateIssuer
7100155050MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110809000434 KY Practitioner - Pediatric Medicine 2466621487 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc CurrentSince Dec 1, 2020 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group, Inc Pediatrics CurrentSince Dec 1, 2020 Accepting new patients
Owensboro Health Medical Group, Inc Pediatrics Past Accepting new patients
Owensboro Health Inc Past Accepting new patients

Locations

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

1000 Breckenridge St
Ste 300
Owensboro, KY 42303
Phone (270) 688-4480

Interoperability endpoints

  • Direct secure messaging: rbooth106833@direct.owensborohealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410480000000",
    "number": "1194997502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 BRYAN BLVD",
            "address_2": "SUITE 200",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012779",
            "telephone_number": "606-528-9700",
            "fax_number": "606-528-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 BRYAN BLVD",
            "address_2": "SUITE 200",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012779",
            "telephone_number": "606-528-9700",
            "fax_number": "606-528-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "REBEKAH",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-25",
        "last_updated": "2014-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "44547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100155050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.