Christine Booher

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

1353885 Issued in TX

Practice address

610 S Jennings Ave Ste E
Fort Worth, TX 76104-3209

Phone

(682) 231-2674

NPI assigned

Feb 21, 2007

Last updated

Jan 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lead Pediatric Physical Therapy, PLLC

  • Pediatric Physical Therapist
  • Fort Worth, TX
  • NPI 1124880240

  Pediatrics

  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1366587909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 RIVERBEND DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761092435",
            "telephone_number": "571-212-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S JENNINGS AVE STE E",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043209",
            "telephone_number": "682-231-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOHER",
        "first_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305204619",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TX",
            "license": "1353885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shavonne Renee Bonner, FNP
• Bonnette Elite Physical Therapy and Wellness
• Alex Bonnette, PT, DPT
• Micah Bonola, DC
• Ciera Bonvillian
• Erin Booher, M.ED., LPC, NCC
• Grant A. Booher, M.D.
• Elizabeth Brooke Booker
• Jay-Sharee Booker
• Jennifer Booker, FNP-C

• Pediatric Physical Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.