Penny D Booth, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN202921 Issued in GA

Practice address

901 18TH St E
Tifton, GA 31794-3648

Phone

(229) 382-7120

NPI assigned

Sep 27, 2006

Last updated

Mar 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tift Regional Health System IncGroup PAC ID 2062745169, 294 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tift Regional Medical Center Hospital, Tifton, GA, CCN 110095
• Southwell Medical, a Campus of TRMC Hospital, Adel, GA, CCN 110101

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: penny.booth@trhs.cernerdirect.com

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.

• Tift Regional Health System Inc

  dba Southwell Mobile Clinic

  • Family Medicine Physician
  • Tifton, GA
  • NPI 1881203305
  Medicare reassignment Care Compare group NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  GA

  Medicare reassignment NPD
• Tift Regional Health System Inc

  dba WorkSmart Occupational Medicine

  • Clinic/Center
  • Tifton, GA
  • NPI 1003980996
  NPD
• Tift Regional Health System Inc

  dba Tift Regional Physicians

  • Internal Medicine Physician
  • Tifton, GA
  • NPI 1326271669
  NPD
• Tift Regional Health System Inc

  dba Tift Regional Ophthalmology

  • Ophthalmology Physician
  • Tifton, GA
  • NPI 1790280857
  NPD
• Tift Regional Health System Inc.

  dba Southwell Medical Community Health Center

  • Rural Health Clinic/Center
  • Tifton, GA
  • NPI 1649800111
  NPD
• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385
  NPD (past)
• Bradley J Richardson MD Ed D Inc

  • Internal Medicine Physician
  • Huntington, WV
  • NPI 1619914702
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tift Regional Health System Inc.

  dba Tift Regional Medical Center

  • General Acute Care Hospital
  • Tifton, GA
  • NPI 1962462226
  Care Compare affiliation
• Tift Regional Health System, Inc.

  dba Southwell Medical

  • General Acute Care Hospital
  • Adel, GA
  • NPI 1568410264
  Care Compare affiliation

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1710078423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 18TH ST E STE 400",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943684",
            "telephone_number": "229-353-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "229-382-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "PENNY",
        "middle_name": "D",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN202921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "penny.booth@trhs.cernerdirect.com",
            "affiliation": "N",
            "address_1": "901 18th St E",
            "city": "Tifton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317943648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Garrett Blalock, PA-C
• Kathryn Blevins, PA
• Bloom Chiropractic, LLC
• David Q Bobo, CRNA
• Rachael Boney-King
• Andrea Boutwell, ST
• Anna Bowen, CRNA
• Jessica Ann Boyd, NP-C
• Lauren Monk Boyett, CCC-SLP
• Parviz Brahman, M.D.

• Family Nurse Practitioner in Tifton, GA
• Providers in Tifton, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.