Edward Philipp Boos

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

007994 Issued in GA

Practice address

6 Executive Park Dr NE
Suite 10
Atlanta, GA 30329-2221

Phone

(404) 321-9900

Fax

(678) 868-2184

NPI assigned

Jun 12, 2016

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

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eboos@poa1811.srs-direct.com
• Direct secure messaging: eboos131513@directwellstar.org

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  • Pulmonary Disease Physician
  • Marietta, GA
  • NPI 1639475270
  NPD
• Wellstar Cardiovascular Medicine, LLC

  • Cardiovascular Disease Physician
  • Marietta, GA
  • NPI 1457320319
  NPD (past)

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

{
    "created_epoch": "1465689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465689600000",
    "number": "1881043644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 EXECUTIVE PARK DR NE",
            "address_2": "SUITE 10",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292221",
            "telephone_number": "404-321-9900",
            "fax_number": "678-868-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 EXECUTIVE PARK DR NE",
            "address_2": "SUITE 10",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292221",
            "telephone_number": "404-321-9900",
            "fax_number": "678-868-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOS",
        "first_name": "EDWARD",
        "middle_name": "PHILIPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-12",
        "last_updated": "2016-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Stephen Booker, RBT
• Clinton L Boomgarden, PA
• Christian Boone, D.D.S.
• Jennifer Keith Boone, PSY.D.
• Kristopher Boone
• Ansley Booth
• Destine Naomi Booth
• Jessica Booth
• Khalil Booth, CRNA
• Laura Ashley Booth

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.