Brenda Galvin Booth, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5000596 Issued in NC

Practice address

1248 Fort Bragg Rd
Fayetteville, NC 28305-4981

Phone

(910) 323-0334

Fax

(888) 391-5874

NPI assigned

Oct 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1255417838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 PARKVIEW AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283054908",
            "telephone_number": "910-323-0334",
            "fax_number": "888-391-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 FORT BRAGG RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283054981",
            "telephone_number": "910-323-0334",
            "fax_number": "888-391-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "BRENDA",
        "middle_name": "GALVIN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5000596",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "2005003026",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDENTIALING CENTER",
            "identifier": "2005003026",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Takisha Anderson Booker, LPC
• Camille Dione Boone, M.A., LMFT
• Gabrielle Boone
• Karen Boone
• Paul D Boone, MD
• Bridget Kathleen Booth, PHD PMHCNS-BC
• Christine Dennett Booth, MD
• Frederick Allen Booth, DDS,MSD
• Morgan Booth, SLP
• Mallory Boozer

• Nurse Practitioner in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.