Elijah Boothe, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP07815 Issued in LA

Practice address

499 Old Columbia Rd
Harrisonburg, LA 71340-3001

Phone

(318) 744-2121

NPI assigned

Mar 23, 2016

Last updated

Mar 23, 2016By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1568824019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 BASTILLE LN",
            "address_2": "SUITE 200",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712707149",
            "telephone_number": "318-475-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 OLD COLUMBIA RD",
            "city": "HARRISONBURG",
            "state": "LA",
            "postal_code": "713403001",
            "telephone_number": "318-744-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTHE",
        "first_name": "ELIJAH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP07815",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN132128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Borne
• Catahoula Parish School Board
• Catahoula Parish School Board
• Tiffany Cater, SLP
• John Joseph Costanza, REGISTERED PHARMACIS

• Family Nurse Practitioner in Harrisonburg, LA
• Providers in Harrisonburg, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.