Individual provider Active NPI

Ronald R Booth, RPH

  • Pharmacist
  • Leavenworth, KS
National Provider Identifier
1225460686
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
1-09248 Issued in KS
Practice address
429 Delaware St
Leavenworth, KS 66048-2732
Phone
(913) 682-1602
Fax
(913) 682-4220
NPI assigned
Aug 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1-09248 KS Primary

Addresses

Primary practice location

429 Delaware St
Leavenworth, KS 66048-2732

Mailing address

429 Delaware St
Leavenworth, KS 66048-2732
Phone (913) 682-1602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
1-09248KSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Corner Pharmacy, Inc. Past Accepting new patients

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": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1225460686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 DELAWARE ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660482732",
            "telephone_number": "913-682-1602",
            "fax_number": "913-682-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 DELAWARE ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660482732",
            "telephone_number": "913-682-1602",
            "fax_number": "913-682-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "RONALD",
        "middle_name": "R",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-09248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.