Individual provider Active NPI

Rose M Boothe

  • Homemaker
  • Saint Louis, MO
National Provider Identifier
1285990119
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
License
01151547 Issued in MO
Practice address
8650 Moran PL Ace
Saint Louis, MO 63114-4437
Phone
(314) 397-0905
Fax
(314) 222-3394
NPI assigned
Apr 4, 2012
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 01151547 MO
Homemaker 376J00000X 01151547 MO Primary

Addresses

Primary practice location

8650 Moran PL Ace
Saint Louis, MO 63114-4437

Mailing address

8650 Moran PL
Saint Louis, MO 63114-4437
Phone (314) 397-0905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
01151547MOMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Hatfill & Boothe Corp Personal Care Attendant Current Accepting new patients

Organizations & group practices 1

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1285990119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8650 MORAN PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631144437",
            "telephone_number": "314-397-0905",
            "fax_number": "314-222-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8650 MORAN PL ACE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631144437",
            "telephone_number": "314-397-0905",
            "fax_number": "314-222-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTHE",
        "first_name": "ROSE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "MO",
            "license": "01151547",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "MO",
            "license": "01151547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.