Lisa Dawn Booth, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19109 Issued in TN

Practice address

3614 Blanding Blvd
Jacksonville, FL 32210-5241

Phone

(904) 419-7100

NPI assigned

Sep 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GBCFAA
• Direct secure messaging: lisabooth@jcpa.allscriptsdirect.net

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366
  NPD (past)
• Dedicated Senior Medical Centers of Florida, LLC

  • Non-Pharmacy Dispensing Site
  • Jacksonville, FL
  • NPI 1295487387
  NPD (past)
• Ultimate Health Clinic North

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1013643998
  NPD (past)
• Ultimate Health Clinic PC

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1669567707
  NPD (past)

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1306248182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-422-0213",
            "fax_number": "731-660-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322105241",
            "telephone_number": "904-419-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Innovation Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383053019",
            "country_code": "US",
            "telephone_number": "731-422-0213",
            "fax_number": "731-422-0475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "LISA",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Boone, ARNP
• Tiffany Boone, PHARMD
• Charles H Booras, M.D.
• Christine Marie Booras, LMT
• Alexa Booth
• Robert Pierce Booth, M.D.
• Hemanth Krishna Boppana, MD
• Ravi Boppana
• Gira Borad, MD
• Nellie N Borba-Nassirou, RPH

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.
• 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.