Individual provider Active NPI

Angela Lee Booth, APRN

  • Family Nurse Practitioner
  • Casper, WY
National Provider Identifier
1477003192
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22031.1556 Issued in WY
Practice address
3632 American Way
Casper, WY 82604-3164
Phone
(307) 234-6765
NPI assigned
Oct 5, 2016
Last updated
Oct 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22031.1556 WY Primary

Addresses

Primary practice location

3632 American Way
Casper, WY 82604-3164

Mailing address

3632 American Way
Casper, WY 82604-3164
Phone (307) 234-6765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161216000997 WY Practitioner - Nurse Practitioner 7315227931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1106 Big Horn Ave
Worland, WY 82401-2803
Phone (307) 347-8801

3632 American Way
Casper, WY 82604-3164

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.9 of 100Reported as group
Quality
68.13
Promoting interoperability
99
Improvement activities
40
Cost
69.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22031.1556WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians West LLC CurrentSince Nov 1, 2023 Accepting new patients
Banner Health Physicians West LLC CurrentSince Nov 1, 2023 Accepting new patients

Locations

1020 S Conwell St
Casper, WY 82601
Phone (307) 265-3622

1106 Big Horn Ave
Worland, WY 82401
Phone (307) 347-3221

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1477003192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3632 AMERICAN WAY",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826043164",
            "telephone_number": "307-234-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 AMERICAN WAY",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826043164",
            "telephone_number": "307-234-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "ANGELA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "22031.1556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.