Active NPI
Gayle O Booth, MS RD LDN CDE
- Registered Dietitian
- Palatine, IL
National Provider Identifier
1851618615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.001309
- Practice address
- 675 N North CT
Suite 270
Palatine, IL 60067-8157 - Phone
- (847) 701-8345
- Fax
- (888) 788-2497
- NPI assigned
- May 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.001309 | IL | Primary |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 164.001309 | IL | |
| Renal Nutrition Registered Dietitian | 133VN1005X | 164.001309 | IL |
Addresses
Primary practice location
675 N North CT
Suite 270
Palatine, IL 60067-8157
Mailing address
415 Machelle Dr
Cary, IL 60013-2399
Phone (847) 701-8345
Other names 1
- Gayle Ann Overmyer
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.001309 | IL | MD | Pediatric Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutridynamic, LLC | Past | Accepting new patients | |
| McHenry Medical Center SC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Chiropractor
- McHenry, IL
- NPI 1366585291
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1851618615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 MACHELLE DR",
"city": "CARY",
"state": "IL",
"postal_code": "600132399",
"telephone_number": "847-701-8345",
"fax_number": "888-788-2497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 N NORTH CT",
"address_2": "SUITE 270",
"city": "PALATINE",
"state": "IL",
"postal_code": "600678157",
"telephone_number": "847-701-8345",
"fax_number": "888-788-2497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTH",
"first_name": "GAYLE",
"middle_name": "O",
"credential": "MS RD LDN CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-03",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.001309",
"primary": true
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "IL",
"license": "164.001309",
"primary": false
},
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "IL",
"license": "164.001309",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GAYLE",
"last_name": "OVERMYER",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Palatine, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.