NPIMap

Individual provider Active NPI

Edward H. Booker Sr., M.D.

  • Family Medicine Physician
  • West Union, SC
National Provider Identifier
1386701563
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9495 Issued in SC
Practice address
1205 N Highway 11
West Union, SC 29696-2715
Phone
(864) 638-5402
Fax
(864) 638-6126
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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 9495 SC Primary

Addresses

Primary practice location

1205 N Highway 11
West Union, SC 29696-2715

Mailing address

PO Box 219
West Union, SC 29696-0219
Phone (864) 638-5402

Other identifiers 1

IdentifierTypeStateIssuer
094953MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041004000781 SC Practitioner - Family Practice 4183683444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Corner Family PracGroup PAC ID 5799836672, 4 clinicians

Practice addresses (Care Compare)

1205 N Hwy 11
West Union, SC 29696-2715
Phone (864) 638-5402

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Greenville, SC, CCN 427017
  • Amedisys Home Health of Clinton Home health agency, Clinton, SC, CCN 427116
  • Interim Healthcare of the Upstate Home health agency, Greenville, SC, CCN 427015
  • Prisma Health Oconee Memorial Hospital Hospital, Seneca, SC, CCN 420009
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Corner Family Prac Family Medicine CurrentSince Aug 1, 2001 Accepting new patients
Booker Family Practice, LLC Family Medicine PastSince Aug 1, 2001 Accepting new patients

Locations

1205 N Highway 11
West Union, SC 29696
Phone (864) 638-5402

Organizations & group practices 2

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.

Hospital & facility affiliations 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1386701563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219",
            "city": "WEST UNION",
            "state": "SC",
            "postal_code": "296960219",
            "telephone_number": "864-638-5402",
            "fax_number": "864-638-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N HIGHWAY 11",
            "city": "WEST UNION",
            "state": "SC",
            "postal_code": "296962715",
            "telephone_number": "864-638-5402",
            "fax_number": "864-638-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "EDWARD",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "9495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094953",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Union, SC

Sources for this page

Verify at the official NPI Registry.