Robert John Booth

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2500 E Enterprise Ave Ste B
Appleton, WI 54913-8556

Phone

(920) 416-8577

NPI assigned

Jun 21, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nystrom and Associates Counseling Wi SCGroup PAC ID 1052729464, 108 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nystrom & Associates Counseling Wi., S.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • La Crosse, WI
  • NPI 1659977866
  Medicare reassignment Care Compare group NPD
• Nystrom & Associates Counseling Wi., S.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
  • NPI 1104549047
  NPD
• Rawhide Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, WI
  • NPI 1841334620
  NPD (past)

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1831768258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 HICKORY LN",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549012510",
            "telephone_number": "877-300-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E ENTERPRISE AVE STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138556",
            "telephone_number": "920-416-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-21",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42251300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Ann Bongers
• Rajreiona Bonilla
• Koren Kaye Bonlander
• Christopher L Booker
• Heather Books, PA
• Yashica Booth
• Nicholas R Bope, MD
• Brian J. Borchardt
• Catherine Jean Borek, OT
• Clark Henry Boren Jr., MD

• Mental Health Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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.