Edward Jackson Booth, PHD, APA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

4650 Taylor Rd BLDG 17a
Bethesda, MD 20889-5638

Phone

(301) 295-2737

NPI assigned

Jun 5, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1487813317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 TAYLOR RD BLDG 17A",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895638",
            "telephone_number": "301-295-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 TAYLOR RD BLDG 17A",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895638",
            "telephone_number": "301-295-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "EDWARD",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "PHD, APA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.