Individual provider Active NPI

Kelsey Lynn Booth, MD

  • Family Medicine Physician
  • Columbus, IN
National Provider Identifier
1356871198
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01083809A Issued in IN
Practice address
2118 25TH St Ste E
Columbus, IN 47201-3240
Phone
(812) 373-2700
Fax
(812) 373-2710
NPI assigned
Jun 14, 2017
Last updated
Sep 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01083809A IN Primary

Addresses

Primary practice location

2118 25TH St Ste E
Columbus, IN 47201-3240

Mailing address

PO Box 775383
Chicago, IL 60677-5383
Phone (812) 376-5315

Other practice location 1

221 North Celia Avenue
IU Health Ball Memorial Family Medicine Residency
Muncie, IN 47303-3428
Phone (765) 747-3141

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbooth16667@edirect.crh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20200709003204 IN Practitioner - Family Practice 1850714783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 17TH St
Columbus, IN 47201-5351
Phone (812) 376-5974

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as apm
Quality
85.1
Promoting interoperability
94.69
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01083809AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Physicians, LLC Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Columbus Regional Health Physicians, LLC Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Major Hospital Past Accepting new patients
Columbus Regional Health Physicians, LLC Family Medicine Past Accepting new patients

Locations

2118 25th St
Ste C
Columbus, IN 47201
Phone (812) 372-8426

2118 25th St
Ste D
Columbus, IN 47201
Phone (812) 372-8281

2118 25th St
Ste E
Columbus, IN 47201
Phone (812) 373-2700

2118 25th St
Ste H
Columbus, IN 47201
Phone (812) 375-3660

2118 25th St
Ste J
Columbus, IN 47201
Phone (812) 372-8426

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

3203 Middle Rd
Columbus, IN 47203
Phone (812) 373-2700

Interoperability endpoints

  • Direct secure messaging: kbooth16667@edirect.crh.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1356871198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 25TH ST STE E",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013240",
            "telephone_number": "812-373-2700",
            "fax_number": "812-373-2710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 North Celia Avenue",
            "address_2": "IU Health Ball Memorial Family Medicine Residency",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473033428",
            "country_code": "US",
            "telephone_number": "765-747-3141",
            "fax_number": "765-741-2977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "KELSEY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01083809A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbooth16667@edirect.crh.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "3203 Middle Dr",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472034427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.