Individual provider Active NPI

Cala Booth

  • Licensed Practical Nurse
  • Stafford, VA
National Provider Identifier
1336661271
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
74885 Issued in NC
Practice address
48 Boundary Dr
Stafford, VA 22556
Phone
(863) 221-5516
NPI assigned
Jul 12, 2017
Last updated
Jul 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 74885 NC Primary

Addresses

Primary practice location

48 Boundary Dr
Stafford, VA 22556

Mailing address

48 Boundary Dr
Stafford, VA 22556-1267

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
74885NCMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1336661271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 BOUNDARY DR",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225561267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 BOUNDARY DR",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "22556",
            "telephone_number": "863-221-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "CALA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "74885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.