Joel Christopher Boothe, RN, BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R878782 Issued in MS

Practice address

1190 N State St
Suite 301
Jackson, MS 39202-2413

Phone

(769) 233-8239

Fax

(769) 233-7865

NPI assigned

Nov 21, 2014

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

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.

• Wintrigg LLC

  • Community/Behavioral Health Agency
  • Flowood, MS
  • NPI 1942591730
  NPD (past)

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1376940130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST",
            "address_2": "SUITE 301",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022413",
            "telephone_number": "769-233-8239",
            "fax_number": "769-233-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 N STATE ST",
            "address_2": "SUITE 301",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022413",
            "telephone_number": "769-233-8239",
            "fax_number": "769-233-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTHE",
        "first_name": "JOEL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-21",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "R878782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leigh Ann Bonvillain, CRNA
• Lindsay Boolos, LPC
• Melody Kristen Boone, MSW
• Tara Jean Booth, NNP-BC
• Emily Boothe
• Brian Bahman Borg, MD, MHSC
• Irina V Borissova, MD, PHD
• Paulo Antonio Borjas Mendoza, MD
• Michael Jude Borne, M.D.
• Barbara Janet Boss, CFNP

• All providers in Jackson, MS
• Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; 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.