MRS. JENNIFER BOYD BOOTLE FNP NPI 1417296898

NPI Information

NPI: 1417296898
Provider Name: MRS. JENNIFER BOYD BOOTLE, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
14089 ABERCORN ST
SAVANNAH, GA
ZIP 31419
Phone: (912) 350-2121
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MRS. Jennifer Boyd Bootle, FNP is a family nurse practitioner in Savannah, GA. MRS. Jennifer Boyd Bootle, FNP NPI is 1417296898. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

14089 ABERCORN ST
SAVANNAH, GA
ZIP 31419-966
Phone: (912) 350-2121
Fax: (912) 350-2145

The NPI 1417296898 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/5/2013 and was last updated on 11/3/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	RN227783	GEORGIA	Yes
2	363LF0000X	Nurse Practitioner	Family	18172	SOUTH CAROLINA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P01241129	OTHER	GEORGIA	RAILROAD MEDICARE
2	20250I7290	MEDICARE PIN	GEORGIA
3	003138354A	MEDICAID	GEORGIA
4	003138354D	MEDICAID	GEORGIA
5	003138354B	MEDICAID	GEORGIA
6	003138354C	MEDICAID	GEORGIA
7	202I502749	MEDICARE PIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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