Active NPI
Kimia Ariannejad Booth
- Family Medicine Physician
- Galveston, TX
National Provider Identifier
1972348159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- BP10089860
- Practice address
- 400 Harborside Dr
Galveston, TX 77555-0001 - Phone
- (409) 747-8593
- NPI assigned
- Jun 28, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | BP10089860 | TX | Primary |
Addresses
Primary practice location
400 Harborside Dr
Galveston, TX 77555-0001
Mailing address
PO Box 650859
Dallas, TX 75265-0859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240706000507 | TX | Order and Referring Only - Family Practice | 1759825383 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1972348159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 650859",
"city": "DALLAS",
"state": "TX",
"postal_code": "752650859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 HARBORSIDE DR",
"city": "GALVESTON",
"state": "TX",
"postal_code": "775550001",
"telephone_number": "409-747-8593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTH",
"first_name": "KIMIA",
"middle_name": "ARIANNEJAD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-28",
"last_updated": "2024-06-28",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "BP10089860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Galveston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.