Spencer K Boothe, PT
Individual provider Active NPI Physical Therapist · Clinton, MS
NPI 1992174452 · NPPES record last updated Dec 11, 2024
Key facts
- NPI
- 1992174452
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT5603 (MS)
- Practice address
- 119 Highway 80 E
Clinton, MS 39056-4738 - Phone
- (601) 708-1834
- Fax
- (601) 708-1837
- NPI assigned
- Sep 15, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Capital Orthopaedic Clinic, PLLC
Practice addresses (Care Compare)
104 Burney Dr
Flowood, MS 39232-6621
Phone (601) 987-8200
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.17 of 100
- Quality
- 82.12
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151029000288 | MS | Practitioner - Physical Therapist in Private Practice | 3577872720 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT5603 | MS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital Orthopaedic Clinic, PLLC | Current |
Accepting new patients | |
| Capital Orthopaedic Clinic PLLC | Current |
Accepting new patients | |
| Capital Orthopedic Clinic PLLC | Past | Accepting new patients |
Locations
119 Highway 80 E
Clinton, MS 39056
Phone (601) 708-1834
104 Burney Dr
Flowood, MS 39232
Phone (601) 987-8202
106 Highland Way
Ste 102
Madison, MS 39110
Interoperability endpoints
- sboothe@colortho.gwaydirect.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT5603 | MS | Yes |
Addresses
Primary practice location
119 Highway 80 E
Clinton, MS 39056-4738
Mailing address
303 Rockbridge Dr
Madison, MS 39110-6989
Phone (601) 278-3578
Other practice location 1
104 Burney Dr
Flowood, MS 39232-6621
Phone (601) 987-8200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200015547 | Medicaid | MS |
Other providers in Clinton, MS
- Arturo Enrique Blanco
- Donan Boggess
- Patrick Lynn Boler
- Shaneka R Boles
- Joseph Boone
- Blake Bostick
- Boujee Bodies Wellness Spa, LLC
- Kimberly Charmaine Branson Williams
- Elizabeth Grace Braswell
- Angela Bratton
All providers in Clinton, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.