Individual provider Active NPI

Nikitia Booth, NP

  • Family Nurse Practitioner
  • Colonial Heights, VA
National Provider Identifier
1275990715
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024173183 Issued in VA
Practice address
3524 Boulevard
Colonial Heights, VA 23834-1320
Phone
(804) 805-8519
Fax
(804) 315-1017
NPI assigned
Jan 27, 2016
Last updated
Mar 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024173183 VA Primary

Addresses

Primary practice location

3524 Boulevard
Colonial Heights, VA 23834-1320

Mailing address

3524 Boulevard
Colonial Heights, VA 23834-1320
Phone (804) 805-8519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20160315002547 VA Practitioner - Nurse Practitioner 2466758503 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloom Geriatrics LLCGroup PAC ID 9537404967, 6 clinicians
Geriatric Associates of Richmond IncGroup PAC ID 4789026071, 22 clinicians

Practice addresses (Care Compare)

1714 E Hundred Rd
Suite 101
Chester, VA 23836-3310
Phone (804) 721-9145

5310 Twin Hickory Rd
Glen Allen, VA 23059-5783
Phone (804) 714-6291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024173183VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP CurrentSince Sep 1, 2024 Accepting new patients
Bloom Geriatrics LLC CurrentSince Dec 1, 2021 Accepting new patients
Clear Ear Solutions, LLC Family CurrentSince Aug 27, 2026 Accepting new patients
Geriatric Associates of Richmond Inc CurrentSince Apr 1, 2025 Accepting new patients
Express Med Urgent Care Center, Inc PastSince Apr 1, 2025 Accepting new patients

Locations

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (317) 701-2379

1714 E Hundred Rd
Ste 101
Chester, VA 23836
Phone (804) 530-5293

3524 Boulevard
Colonial Hgts, VA 23834
Phone (347) 242-6358

5310 Twin Hickory Rd
Glen Allen, VA 23059
Phone (804) 360-4242

46531 Leesburg Pike
Sterling, VA 20164
Phone (703) 834-5800

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1275990715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 BOULEVARD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341320",
            "telephone_number": "804-805-8519",
            "fax_number": "804-315-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 BOULEVARD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341320",
            "telephone_number": "804-805-8519",
            "fax_number": "804-315-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "NIKITIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-27",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.