Alexis Booth, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

43302 Issued in CA

Practice address

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

Phone

(650) 823-9453

NPI assigned

Nov 23, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1245604644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 PEBBLE BEACH DR",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284438050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575",
            "telephone_number": "650-823-9453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Garden View Ct Ste 103",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920242478",
            "country_code": "US",
            "telephone_number": "760-632-6942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "ALEXIS",
        "credential": "DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "43302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Outlook",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 Brewster Blvd",
            "city": "Camp Lejeune",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285472575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jared Bollinger
• Jillian Wagner Bonaroti, MD
• Julia E. Bond, WHCNP
• Rock Boney
• Christine Ann Boone, PMHNP-BC
• Johnathan Andrew Boswell, IDC
• Bryan Edward Bouchard, IDC
• Lee Edward Boujie, PA-C
• Betty M Bowen, NP
• Daniel Bowen, MD

• Physical Therapist in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.