Jack Branyon Booth, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

35-036061 Issued in OH

Practice address

930 Bethesda Dr. BLDG 4
Zanesville, OH 43701-0815

Phone

(740) 455-6202

NPI assigned

Dec 12, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Genesis Professional Corp

  • General Practice Physician
  • Zanesville, OH
  • NPI 1497755623

  Otolaryngology

  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1982765152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 BETHESDA DR. BLDG 4",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437010815",
            "telephone_number": "740-455-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 BETHESDA DR. BLDG 4",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437010815",
            "telephone_number": "740-455-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "JACK",
        "middle_name": "BRANYON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35-036061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0274206",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobi Jo Bonar, OTR/L
• Tierany Lea Bone, BA, LSW
• Jordan Bonier, D.O.
• Courtney Anne Bonner, D.O.
• Rebecca Bookless, L.P.N.
• Farid Bounif, MD
• Jacob Vincent Bourget
• John Alan Bova, LPC, LICDC, CNP-BC
• Rebecca S. Bowden, PT, DPT
• Iisha Boxley

• Otolaryngology Physician in Zanesville, OH
• Providers in Zanesville, OH by specialty
• Otolaryngology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.