Annie Shehade Booth
Individual provider Active NPI Family Nurse Practitioner · Louisville, KY
NPI 1457034167 · NPPES record last updated Aug 9, 2023
Key facts
- NPI
- 1457034167
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4001374 (KY)
- Practice address
- 170 Dr Arla Way
Suite 101
Louisville, KY 40229-5427 - Phone
- (502) 955-8480
- NPI assigned
- Aug 9, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Abode Care Partners LTC VB LLC
SHC Medical Partners of Kentucky, LLC
Practice addresses (Care Compare)
2529 Six Mile LN
Louisville, KY 40220-2934
Phone (502) 491-5560
708 Bartley Ave
Bardstown, KY 40004-1240
Phone (502) 348-9260
Hospital & facility affiliations
- Baptist Health Hardin
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231003003143 | KY | Practitioner - Nurse Practitioner | 0446604870 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SHC Medical Partners of Kentucky, LLC | Current |
Accepting new patients | |
| Abode Care Partners LTC VB, LLC | Current |
Accepting new patients | |
| Abode Care Partners Al VB, LLC | Current |
Accepting new patients | |
| Abode Care Partners LTC VB, LLC | Current |
Accepting new patients | |
| Abode Care Partners Al VB, LLC | Current |
Accepting new patients |
Locations
708 Bartley Ave
Bardstown, KY 40004
Phone (502) 348-9260
2529 Six Mile Ln
Louisville, KY 40220
Phone (502) 491-5560
805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438
12201 Bluegrass Pkwy
Louisville, KY 40299
Phone (502) 568-7364
805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4001374 | KY | Yes |
Addresses
Primary practice location
170 Dr Arla Way
Suite 101
Louisville, KY 40229-5427
Mailing address
170 Dr Arla Way
Suite 101
Louisville, KY 40229-5427
Phone (502) 955-8480
Other providers in Louisville, KY
- Suzanne M Boone
- William Francis Boone
- Zequoria Boone
- Surya Boopathy
- Alice Boos-Edwards
- Migion Migion Booth
- Rebecca J Booth
- Stephen J Booth
- Jodee Borah
- Lawrence Harold Boram
All providers in Louisville, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.