Individual provider Active NPI

Diane M. Booth, APRN

  • Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1922306398
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN695902 Issued in FL
Practice address
1600 Lakeland Hills Blvd.
Lakeland, FL 33805-3019
Phone
(863) 680-7000
Fax
(866) 264-8519
NPI assigned
Mar 8, 2011
Last updated
Jun 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN695902 FL Primary

Addresses

Primary practice location

1600 Lakeland Hills Blvd.
Lakeland, FL 33805-3019

Mailing address

4324 Cleveland Heights Blvd
Lakeland, FL 33813-1706
Phone (863) 698-6827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20110408000504 FL Practitioner - Nurse Practitioner 0446434831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.18 of 100Reported as apm
Quality
70.68
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Watson Clinic LLP Past Accepting new patients

Locations

1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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

NPI Registry JSON

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1922306398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4324 CLEVELAND HEIGHTS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131706",
            "telephone_number": "863-698-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD.",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "DIANE",
        "middle_name": "M.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN695902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.