Wyatt Boothby-Shoemaker, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

1326781220 Issued in MI

Practice address

200 Health Park Dr Ste 205
Owosso, MI 48867-1291

Phone

(989) 723-8666

NPI assigned

Apr 18, 2022

Last updated

Jul 9, 2026By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: wboothbyshoemaker684993@direct.hfhs.org

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1326781220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HEALTH PARK DR STE 205",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTH PARK DR STE 205",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671291",
            "telephone_number": "989-723-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTHBY-SHOEMAKER",
        "first_name": "WYATT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-18",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "1326781220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Bolger
• Mandell Tony Bookman, M.D.
• Sasha Mae Boon, MSOT, OTRL
• Adrian Marie Boone
• Chloria D Boone
• Tiffany Borregard
• Deborah Wachter Boucha, LMSW
• Cassondra Boulis
• Jonathon Boulis
• Alison Marie Bowers, NURSE PRACTITIONER

• Dermatology Physician in Owosso, MI
• Providers in Owosso, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.