CARRIE JEAN BOOTS (NPI# 1003012352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003012352 |
| Entity Type | Individual |
| Full Name | CARRIE JEAN BOOTS |
| Other Name | CARRIE JEAN BALLER |
| Credential | N.P. |
| Practice Address |
7910 W Jefferson Blvd Ste 108 Fort Wayne IN 46804-4159 |
| Mailing Address |
6610 Mutual Dr Fort Wayne IN 46825-4236 |
| Practice Telephone | 2604848830 |
| Practice Fax Number | 2604831911 |
| Mailing Telephone | 2604848830 |
| Mailing Fax Number | 2604831911 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-07-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
71002416A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7910 W JEFFERSON BLVD STE 108 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073515987 | Praveen Kollipara | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2005-08-10 |
| 1831796762 | Tara Lynn Leland | Nurse Practitioner | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2020-10-05 |
| 1508330796 | Shelley D Seabolt | Nurse Practitioner | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2019-01-22 |
| 1265819064 | Guinevere M Nilles | Physician Assistant | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2015-04-30 |
| 1891968301 | Sunil Babu | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2008-04-04 |
| 1134330061 | Ryan A Gonzales | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2007-05-24 |
| 1861525560 | Ahad Ali Sadiq | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2007-03-13 |
| 1639148232 | David M Zimmerman | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2006-03-16 |
| 1831173269 | Yasolatha Nalamolu | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2005-11-30 |
| 1447252135 | Matthew L Carr | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2005-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548626229 | Tina Duncan | Nurse Practitioner | 6732 Covington Creek Trl, Fort Wayne, IN 46804-2870 | 2016-01-11 |
| 1538486691 | Rounding Providers | Nurse Practitioner | 14411 Smugglers Notch, Fort Wayne, IN 46814-8701 | 2010-04-29 |
| 1245428366 | Damon Greven | Nurse Practitioner | 2512 E Dupont Rd Ste 100, Fort Wayne, IN 46825-1609 | 2007-10-15 |
| 1467658740 | Kimberly E Recht | Nurse Practitioner | 11108 Parkview Circle, Suite 5100, Fort Wayne, IN 46845 | 2007-06-25 |
| 1083827539 | Ruth Elaine Wartell | Nurse Practitioner | 8107 Tranquilla Pl, Fort Wayne, IN 46815-5781 | 2007-05-08 |
| 1285756874 | Timothy John Murphy | Nurse Practitioner | 3617 Rockwood Dr, Fort Wayne, IN 46815-6144 | 2007-04-04 |
| 1962490839 | Peggy A Ryan | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2005-10-13 |
| 1265095897 | Ashley Kamea Lynn Brown | Nurse Practitioner | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 | 2019-04-18 |
| 1104398833 | Jessica Marie Bolton | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815 | 2018-12-19 |
| 1750868568 | Shannon E Sitgreaves | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2018-07-24 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on CARRIE JEAN BOOTS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.