Timantha D Booth, PA
Individual provider Active NPI Physician Assistant · Adel, GA
NPI 1265748867 · NPPES record last updated Mar 30, 2021
Key facts
- NPI
- 1265748867
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 005888 (GA)
- Practice address
- 172 MJ Taylor Rd
Adel, GA 31620-3497 - Phone
- (229) 896-3424
- Fax
- (229) 896-3838
- NPI assigned
- Aug 20, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Mercer University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tift Regional Health System Inc
Practice addresses (Care Compare)
150 MJ Taylor Rd
Adel, GA 31620-3497
Phone (229) 896-8440
172 MJ Taylor Rd
Adel, GA 31620-3497
Phone (229) 896-8500
Hospital & facility affiliations
- Southwell Medical, a Campus of TRMC
- Tift Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.02 of 100
- Quality
- 57.87
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.97
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110225000107 | GA | Practitioner - Physician Assistant | 3577744465 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005888 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tift Regional Health System Inc | Current |
Accepting new patients | |
| Tift Regional Health System Inc | Current |
Accepting new patients | |
| Tift Regional Health System Inc | Current |
Accepting new patients | |
| Tift Regional Health System, Inc. | Current | Accepting new patients | |
| Tift Regional Health System Inc | Current |
Accepting new patients | |
| Tift Regional Health System, Inc. | Past | Accepting new patients |
Locations
706 N Parrish Ave
Adel, GA 31620
Phone (229) 896-8000
308 N Parrish Ave
Adel, GA 31620
Phone (229) 247-2290
172 Mj Taylor Rd
Adel, GA 31620
Phone (229) 896-3424
103 James St
Adel, GA 31620
Phone (229) 245-0666
260 Mj Taylor Rd
Adel, GA 31620
Phone (229) 247-2290
2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422
2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188
1622 Madison Ave
Tifton, GA 31794
Phone (229) 387-8061
907 18th St E
Ste 400
Tifton, GA 31794
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/6e2dde13-d4ea-4659-900f-6a252ed00859/
- timantha.booth@trhs.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005888 | GA | Yes |
Addresses
Primary practice location
172 MJ Taylor Rd
Adel, GA 31620-3497
Mailing address
907 18TH St E Ste 400
Tifton, GA 31794-3684
Phone (229) 353-3422
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005888 | Other | GA | 005888 |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | timantha.booth@trhs.cernerdirect.com |
Other providers in Adel, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.