Individual provider Active NPI

Eugene Booher, CRNA

  • Certified Registered Nurse Anesthetist
  • Raceland, LA
National Provider Identifier
1386744654
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN032157 Issued in TX
Practice address
4608 Highway 1
Raceland, LA 70394-2623
Phone
(985) 537-6841
Fax
(985) 537-8273
NPI assigned
Sep 25, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN032157 TX Primary

Addresses

Primary practice location

4608 Highway 1
Raceland, LA 70394-2623

Mailing address

4608 Highway 1
Raceland, LA 70394-2623
Phone (985) 537-6841

Other identifiers 1

IdentifierTypeStateIssuer
1397369MedicaidLA

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN032157TXMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386744654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 HIGHWAY 1",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "703942623",
            "telephone_number": "985-537-6841",
            "fax_number": "985-537-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 HIGHWAY 1",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "703942623",
            "telephone_number": "985-537-6841",
            "fax_number": "985-537-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOHER",
        "first_name": "EUGENE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "RN032157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1397369",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raceland, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.