Active NPI
Alexander Tyler Booth, MD
- Colon & Rectal Surgery Physician
- Charleston, SC
National Provider Identifier
1790389112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- MD98051
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| LL52637 | SC | MD | Surgery Physician |
Interoperability endpoints
- 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.