DR. KELEY JOHN BOOTH (NPI# 1558387696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558387696 |
| Entity Type | Individual |
| Full Name | DR. KELEY JOHN BOOTH |
| Credential | MD |
| Practice Address |
4401 S Western Ave Oklahoma City OK 73109-3413 |
| Mailing Address |
Po Box 6491 Norman OK 73070-6491 |
| Practice Telephone | 9186649892 |
| Practice Fax Number | 9186642521 |
| Mailing Telephone | 4059478585 |
| Mailing Fax Number | 4059486507 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2015-12-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 22940 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE | 433243ZPYY | 01 |
| OK | 200087480A | 05 |
| Street Address |
4401 S WESTERN AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73109-3413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922091511 | Ralph Oscar Shadid | Internal Medicine | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2005-08-29 |
| 1255939245 | Osu Center for Health Scienses | Clinic/Center | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2020-10-13 |
| 1740898030 | Ashley Nicole Newberry | Occupational Therapist | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2020-07-22 |
| 1306461512 | Alicia Ablola Chaparro | Registered Nurse | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2020-06-12 |
| 1700408309 | Nina G Stevens | Student in an Organized Health Care Education/Training Program | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2020-05-18 |
| 1174145767 | Jesse P Pandian | Student in an Organized Health Care Education/Training Program | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2020-05-18 |
| 1578185435 | Robert William Soult | Student in an Organized Health Care Education/Training Program | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2020-05-14 |
| 1669094579 | Tyler L Woolum | Student in an Organized Health Care Education/Training Program | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2020-05-13 |
| 1588286546 | Landon Riesenberg | Student in an Organized Health Care Education/Training Program | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2020-05-13 |
| 1225650138 | Shelby Tripod | Student in an Organized Health Care Education/Training Program | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2020-05-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063905354 | Housecalls | Family Medicine | 4413 S Lee Ave, Oklahoma City, OK 73109 | 2018-06-11 |
| 1225559404 | John Nathan Jacobsen | Dentist | 235 Sw 25th St., Oklahoma City, OK 73109 | 2017-06-28 |
| 1659828648 | Cynthia Jane Laney | Registered Nurse | 4401 South Western, Oklahoma City, OK 73109 | 2016-09-07 |
| 1497104780 | Hazel Soto | Case Manager/Care Coordinator | 420 Sw, St, Oklahoma, OK 73109 | 2016-06-07 |
| 1063873677 | Ardeceley Brandi Annette Hernandez | Community/Behavioral Health | 5714 S. Western Ave, Oklahoma City, OK 73109 | 2016-03-09 |
| 1316343908 | Van Ngo | Nurse Practitioner | 4413 South Lee Ave, Oklahoma City, OK 73109 | 2014-11-10 |
| 1104249150 | Janessa Ladawn Bointy | Counselor | 5359 S. Western Ave. #707, Oklahoma City, OK 73109 | 2014-01-28 |
| 1033540299 | Bryan Graham | Case Manager/Care Coordinator | 1111 Sw 28th St, Oklahoma City, OK 73109 | 2013-12-12 |
| 1154684603 | Nubia Fiesel | Counselor | 420 Sw 10th Street, Oklahoma City, OK 73109 | 2012-06-20 |
| 1548533664 | C.c. Freeman, Md. Inc | Internal Medicine | 4221 S. Western Ave., Suite 2015, Oklahoma City, OK 73109 | 2012-02-21 |
| Find all providers in zip 73109 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417463548 | Integrated Anesthesia Services, Pllc | Anesthesiology | 5030 N May # 291, Oklahoma City, OK 73112-6010 | 2017-12-27 |
| 1942710066 | Christopher C. Shadid, Md, Pllc | Anesthesiology | 837 Nw 41st St, Oklahoma City, OK 73118-6822 | 2017-10-03 |
| 1699124297 | Sterling Etim Euk Udom | Anesthesiology | 750 Ne 13th, Suite 200, College of Medicine, Oklahoma City, OK 73104 | 2016-06-06 |
| 1710331079 | Joseph Mosley | Anesthesiology | 750 Ne 13th Oac 200, Oklahoma City, OK 73104 | 2016-04-22 |
| 1639570427 | Rrm Medical Pllc | Anesthesiology | 3048 Sw 89th St Ste A, Oklahoma City, OK 73159-6359 | 2014-09-11 |
| 1962763110 | Sheila Busch Campbell | Anesthesiology | 3532 Quail Creek Rd, Oklahoma City, OK 73120-8911 | 2012-06-05 |
| 1497012272 | Neda Sadeghi | Anesthesiology | 12016 Dahoon Dr, Oklahoma City, OK 73120-8131 | 2012-04-18 |
| 1861760837 | John Bernard Gilleran | Anesthesiology | 4940 Nw 31st St, Oklahoma City, OK 73122 | 2011-12-06 |
| 1609161231 | Ksenia Koltun | Anesthesiology | 13321 N. Meridian Suite 402, Oklahoma City, OK 73120 | 2011-06-11 |
| 1861722357 | Anesthesia and Tee Services, PC | Anesthesiology | 149 Lake Aluma Dr, Oklahoma City, OK 73121-3401 | 2010-01-05 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73109 |
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| 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.