Jeremy Booty, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5947 Issued in CT

Practice address

47 Town St
Norwich, CT 06360-2323

Phone

(860) 892-7042

NPI assigned

Oct 27, 2014

Last updated

Jan 20, 2015By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Community and Family Services, IncGroup PAC ID 9032012497, 71 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbooty295598@direct.ochin.org

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

• United Community and Family Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norwich, CT
  • NPI 1467482539
  Medicare reassignment Care Compare group NPD
• United Community and Family Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norwich, CT
  • NPI 1558366757
  NPD

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1669877189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 TOWN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602323",
            "telephone_number": "860-892-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 TOWN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602323",
            "telephone_number": "860-892-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTY",
        "first_name": "JEREMY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-27",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "5947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Jean Bonchuk
• Stephie Jovanie Bonheur
• Kathleen Bonin, APRN
• Kristin Bonner, LCSW
• Kathryn H Bony, OD
• Denise E Boras, APRN
• Krystyna E Borkowski, MS
• Michelle Bosco, PSY.D.
• Olivia Rae Bottini, DPT, PT
• Johnda Ann Bouthillier, LCSW, LADC

• Psychiatric/Mental Health Nurse Practitioner in Norwich, CT
• Providers in Norwich, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.