Rebecca Anne Booker, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

GAA-NP002105 Issued in GA

Practice address

311 Gwinnett Dr
Lawrenceville, GA 30046-5671

Phone

(770) 910-9196

Fax

(770) 910-9197

NPI assigned

Sep 22, 2022

Last updated

Jun 3, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, OR, TX3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

• Phoenix Restorative Care Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Lubbock, TX
  • NPI 1861377756
  Medicare reassignment NPD Authorized official
• Advantage Behavioral Health Systems

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Athens, GA
  • NPI 1942270558
  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  OR

  Medicare reassignment NPD

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1831812056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6706 90TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794246729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 GWINNETT DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465671",
            "telephone_number": "770-910-9196",
            "fax_number": "770-910-9197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2467 Old Cornelia Hwy",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "30507",
            "country_code": "US",
            "telephone_number": "678-960-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "GAA-NP002105",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "787163",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Boneberg, M.S.
• Alahni Bones
• Stephanie Carolina Bono
• Mary Alice McBurney Bonselaar, PT, DPT
• Megan E Bonselaar, OTR/L
• Shalanda Monique Booker
• Shirley Boone-Sanford, PH.D.
• Boostcare LLC
• Jacqueline Boreland, RN
• Ashley Attaway Born

• Psychiatric/Mental Health Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.