Individual provider Active NPI

Ryan H Boothe, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1609419142
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
226867 Issued in AZ
Practice address
500 W Thomas Rd Ste 230
Phoenix, AZ 85013-4245
Phone
(602) 406-9999
Fax
(602) 406-8099
NPI assigned
Oct 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 226867 AZ Primary

Addresses

Primary practice location

500 W Thomas Rd Ste 230
Phoenix, AZ 85013-4245

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Other practice location 1

1050 Gail Gardner Way Ste 300
Prescott, AZ 86305-1640
Phone (602) 406-4786

Other identifiers 1

IdentifierTypeStateIssuer
125664MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220524002490 AZ Practitioner - Nurse Practitioner 5092192443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sjhmc Physician Services 645 clinicians

Practice addresses (Care Compare)

500 W Thomas Rd
230 DHMG Behavioral Health St. Joseph'S
Phoenix, AZ 85013-4245
Phone (602) 406-9999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Dec 6, 2025 Accepting new patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
Sjhmc Physician Services CurrentSince Jun 1, 2022 Accepting new patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Dec 6, 2025 Accepting new patients

Locations

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

3030 N Central Ave
Ste 1001
Phoenix, AZ 85012

500 W Thomas Rd
Ste 230
Phoenix, AZ 85013
Phone (602) 406-9999

1050 Gail Gardner Way
Ste 300
Prescott, AZ 86305
Phone (928) 717-5232

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

File 56765
Los Angeles, CA 90074

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1609419142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134245",
            "telephone_number": "602-406-9999",
            "fax_number": "602-406-8099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Gail Gardner Way Ste 300",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863051640",
            "country_code": "US",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOTHE",
        "first_name": "RYAN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-28",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "226867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125664",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.