Jessica D Booth

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP0011851 Issued in WV

Practice address

300 W Main St
Bridgeport, WV 26330-1751

Phone

(304) 842-3131

NPI assigned

Dec 2, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1679110290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 KAUSTIN DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265017229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MAIN ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301751",
            "telephone_number": "304-842-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "JESSICA",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "RP0011851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "RP0011851",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Jessica.Booth@riteaid.com",
            "affiliation": "N",
            "address_1": "300 W Main St",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263301751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevanna Bolton
• Landyn Paige Bonamico
• Mia Isabella Bonasso, PA-C
• Holly Elizabeth Bond
• Michael D Bond
• Chad Michael Boram, LPC
• Melissa M Bourgeois, FNP
• Anne Marie Bower, MA
• Kerri C Bowling
• BP WV Maplewood Leasing Co., LLC (Maplewood Healthcare Center)

• Community/Retail Pharmacy in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Community/Retail Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.