William J Booth, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50.000525RX Issued in OH

Practice address

540 Lincoln Park Blvd. Suite 390
Kettering, OH 45429

Phone

(937) 296-1128

Fax

(937) 296-1728

NPI assigned

Oct 16, 2008

Last updated

Mar 5, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: william.booth.1@28600.direct.athenahealth.com

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.

• South Dayton Pediatrics

  • Pediatrics Physician
  • Kettering, OH
  • NPI 1033243993
  NPD (past)

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1386896710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 LINCOLN PARK BLVD. SUITE 390",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "45429",
            "telephone_number": "937-296-1128",
            "fax_number": "937-296-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 LINCOLN PARK BLVD. SUITE 390",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "45429",
            "telephone_number": "937-296-1128",
            "fax_number": "937-296-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.000525",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.000525RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "50.000525",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0109017",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Bonanni
• Cassandra Bond
• Thomas Bonifield
• Jamie Bonner
• Sandra Bontatibus, CRNA
• Jonathan A Borden, MD
• Emily Brooke Boucher, PA-C
• Peter A Bouz, MD
• Kristie Bovee, MD
• Shelby Diane Bowers

• Medical Physician Assistant in Kettering, OH
• Providers in Kettering, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.