Jennifer A Booth, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3008566 Issued in KY

Practice address

1600 Breckenridge St
Owensboro, KY 42303-1055

Phone

(270) 686-7744

NPI assigned

May 27, 2014

Sex

Female

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 1

Other names 1

• Jennifer Agner Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Green River District Health Dept

  • Public Health or Welfare Agency
  • Owensboro, KY
  • NPI 1295895324
  Medicare reassignment NPD
• Green River District Health Dept

  • Public Health or Welfare Agency
  • Hartford, KY
  • NPI 1053385252
  NPD
• Green River District Health Dept

  • Home Health Agency
  • Owensboro, KY
  • NPI 1063409266
  NPD
• Green River District Health Dept

  • Public Health or Welfare Agency
  • Hawesville, KY
  • NPI 1164495438
  NPD
• Green River District Health Dept

  • Public Health or Welfare Agency
  • Henderson, KY
  • NPI 1356313498
  NPD
• Green River District Health Dept

  • Public Health or Welfare Agency
  • Morganfield, KY
  • NPI 1417937822
  NPD
• Green River District Health Dept

  • Public Health or Welfare Agency
  • Dixon, KY
  • NPI 1548234834
  NPD
• Green River District Health Dept

  • Public Health or Welfare Agency
  • Calhoun, KY
  • NPI 1942273206
  NPD

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497167472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 BRECKENRIDGE ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031054",
            "telephone_number": "270-686-7747",
            "fax_number": "270-926-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 BRECKENRIDGE ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031055",
            "telephone_number": "270-686-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3008566",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497167472",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "AGNER",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bon Harbor RX, LLC
• James Wes Booker, DMD
• Kerri Booker
• Valorie G Boone, CSW
• Alysia Booth, LCSW
• Robin Booth, P.A.
• Kevin L. Boothe, DPT
• Kristin P. Boothe, APRN
• Ada Lynn Bosley, OTR/L
• Lisa M Bosley, LCSW

• Family Nurse Practitioner in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.