Roger Mark Booth Jr., APRN-CNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

105246 Issued in WV

Practice address

1540 Spring Valley Dr
Huntington, WV 25704-9501

Phone

(304) 429-6741

Fax

(215) 842-4233

NPI assigned

Jun 28, 2020

Sex

Male

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

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1593302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1275150047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257049501",
            "telephone_number": "304-429-6741",
            "fax_number": "215-842-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257049501",
            "telephone_number": "304-429-6741",
            "fax_number": "215-842-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "ROGER",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-28",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WV",
            "license": "105246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Huntington",
            "affiliation": "N",
            "address_1": "1540 Spring Valley Dr",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257049501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carolyn C Bond
• Mikayla Boone, RD
• Amanda Booth, FNP-BC
• Kenaja Booth
• Richard Booth Jr., M.D.
• Traci Lynn Booth, FNP-BC
• Alyssa Brooke Boothe
• Corey Alan Boothe, PSYD
• Lloyd Dalton Border, MD
• Rachel R Borders

• Gerontology Nurse Practitioner in Huntington, WV
• Providers in Huntington, WV by specialty
• Gerontology Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.