Justin Mark Booth, AA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

005470 Issued in GA

Practice address

2310 N Patterson St
BLDG C
Valdosta, GA 31602-2568

Phone

(229) 244-6852

Fax

(229) 242-2385

NPI assigned

Nov 12, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valdosta Anesthesia Associates, P.C.Group PAC ID 0941296636, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

Practice roles

Locations

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

• Valdosta Anesthesia Associates, P.C.

  • Specialist
  • Valdosta, GA
  • NPI 1134148208
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Georgia Medical Center Inc

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Care Compare affiliation

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226448000000",
    "number": "1306090675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 N PATTERSON ST",
            "address_2": "BLDG C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022568",
            "telephone_number": "229-244-6852",
            "fax_number": "229-242-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 N PATTERSON ST",
            "address_2": "BLDG C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022568",
            "telephone_number": "229-244-6852",
            "fax_number": "229-242-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "JUSTIN",
        "middle_name": "MARK",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-12",
        "last_updated": "2008-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "005470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA LICENSE",
            "identifier": "005470",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather F Blanchard, MED. CCC-SLP
• Brian Dewayne Blanton Jr., PA-C
• Blissett Health Service
• Daniel Lock Boatright, CRNA
• Samuel Thomas Bobo, PHARM.D.
• Mildred Itaska Borowski, LPC
• Morgan Brooke Boruff, OTR/L
• Elizabeth Ann Bostic, FNP-C
• Rebecca S Bourquine
• Chastidy Boutin

• Anesthesiologist Assistant in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Anesthesiologist Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.