Edgar Booth, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

1789851205 Issued in UT

Practice address

3725 W 4100 S
Ste 102
West Valley City, UT 84120-5417

Phone

(801) 652-4466

NPI assigned

Jul 13, 2005

Last updated

Mar 6, 2019By the provider in NPPES

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hunter Imaging Associates, PC

  • Diagnostic Radiology Physician
  • West Valley City, UT
  • NPI 1346240447
  Authorized official Same address or phone
• University Radiology Associates

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1639124498
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1710985726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1169",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840111169",
            "telephone_number": "801-296-2113",
            "fax_number": "801-296-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 W 4100 S",
            "address_2": "STE 102",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205417",
            "telephone_number": "801-652-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "EDGAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "1789851205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114168600",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D0432",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805426200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelet Bleyl, PA-C
• Filita Bloomfield
• Halie Boardman, CSW
• Kaitlin Bodily, CSW
• Robyn E Boehmer, PAC
• Joseph Borshanian, NP
• Talmage Lee Bourne, MD
• Charles Mikell Bova, M.D.
• Corinne Bowen
• Todd Alan Bowman Sr., D.M.D.

• Diagnostic Radiology Physician in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Diagnostic Radiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.