Charles Moore Boothby, DO

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

License

OS4598 Issued in FL

Practice address

3890 Tampa Rd
Suite 201
Palm Harbor, FL 34684-3676

Phone

(727) 781-3111

Fax

(727) 781-3113

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Advanced Wound Systems LLC

  • Durable Medical Equipment & Medical Supplies
  • St Petersburg, FL
  • NPI 1508054271
  NPD (past)
• Baxley Emergency Physicians LLC

  • Emergency Medicine Physician
  • New Port Richey, FL
  • NPI 1538118484
  NPD (past)
• Brodrick ER SVCS Partnership LLC

  • Emergency Medicine Physician
  • St Petersburg, FL
  • NPI 1467400796
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1588600092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25513",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336225513",
            "telephone_number": "727-823-2188",
            "fax_number": "727-828-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 TAMPA RD",
            "address_2": "SUITE 201",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843676",
            "telephone_number": "727-781-3111",
            "fax_number": "727-781-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTHBY",
        "first_name": "CHARLES",
        "middle_name": "MOORE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "OS4598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069165800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josh Bly, D.C.
• Cindy E Boehm, LMT
• Andres Amilcar Bonelli, M.D.
• Paige Bonilla, APRN
• Robyn Jennifer Boone
• Arianna Borrero Marana, RCSWI
• Cayla Bosman
• Ion Botnaru, M.D.
• Christie Bott, DPT
• Jeanne Ryan Botz, ARNP

• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.