Individual provider Active NPI

Alexander Tyler Booth, MD

  • Colon & Rectal Surgery Physician
  • Charleston, SC
National Provider Identifier
1790389112
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
MD98051 Issued in SC
Practice address
30 Courtenay Drive MSC 295
Charleston, SC 29425-0001
Phone
(843) 792-1414
NPI assigned
Jun 13, 2018
Reactivated
Nov 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X MD98051 SC Primary
Surgery Physician 208600000X MD98051 SC

Addresses

Primary practice location

30 Courtenay Drive MSC 295
Charleston, SC 29425-0001

Mailing address

PO Box 751461
Charlotte, NC 28275-1461

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL52637SCMDSurgery Physician

Interoperability endpoints

  • Direct secure messaging: abooth191964@uihealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1790389112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 COURTENAY DRIVE MSC 295",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250001",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "replacement_npi": "1790389112",
        "last_name": "BOOTH",
        "first_name": "ALEXANDER",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-13",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "deactivation_date": "2020-10-20",
        "reactivation_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "SC",
            "license": "MD98051",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "MD98051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "30 Courtenay Drive Msc 295",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294250001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.