DR. GREGORY TYLER BOOTH (NPI# 1639779150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639779150 |
| Entity Type | Individual |
| Full Name | DR. GREGORY TYLER BOOTH |
| Credential | PHARM.D. |
| Practice Address |
2760 N Dirksen Pkwy Springfield IL 62702-1448 |
| Mailing Address |
2300 Gander Rd Springfield IL 62711-8199 |
| Practice Telephone | 2175224054 |
| Practice Fax Number | 2175224075 |
| Mailing Telephone | 2176529593 |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2020-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 59336 | TX | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 051295476 | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073827333 | Gregory John Booth | Dentist | 9733 W Ustick Rd, Boise, ID 83704-5202 | 2010-07-28 |
| 1801007018 | Gregory Richard Booth | Pediatrics | 621 S New Ballas Rd Ste 2016b, Saint Louis, MO 63141-8265 | 2007-05-28 |
| 1598182693 | Gregory Booth | Anesthesiology | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2014-03-26 |
| 1730299694 | Gregory Alan Booth | Dentist | 1245 Capitol St, 101s., Ogden, UT 84401-2847 | 2006-08-30 |
| 1760417448 | Gregory Booth | Physical Therapist | 38690 Stivers St, Fremont, CA 94536-5336 | 2006-07-11 |
| Street Address |
2760 N DIRKSEN PKWY |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-1448 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396762688 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 2760 N Dirksen Pkwy, Springfield, IL 62702-1448 | 2006-07-16 |
| 1598365314 | Lauren Ballweg | Pharmacist | 2760 N Dirksen Pkwy, Springfield, IL 62702-1448 | 2020-10-30 |
| 1124628581 | Kirk Klein | Pharmacist | 2760 N Dirksen Pkwy, Springfield, IL 62702-1448 | 2020-10-27 |
| 1326667122 | Ridge Lin | Pharmacist | 2760 N Dirksen Pkwy, Springfield, IL 62702-1448 | 2020-04-11 |
| 1194054452 | Tristate Professional Services Inc | Optometrist | 2760 N Dirksen Pkwy, Attn: Walmart Vision Ctr, Springfield, IL 62702-1448 | 2009-12-16 |
| 1407939952 | Wal-mart Stores, Inc | Technician/Technologist | 2760 N Dirksen Pkwy, Springfield, IL 62702-1448 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946299 | Vy Dang | Pharmacist | 45 Willow St Apt 510, Springfield, MA 01103-1966 | 2020-09-15 |
| 1114539756 | Logan Meredith Haley | Pharmacist | 6039 New Chapel Rd, Springfield, TN 37172-1338 | 2020-08-17 |
| 1801413349 | Tung Tran | Pharmacist | 1028 Lincoln Ave, Springfield, PA 19064-3923 | 2020-07-01 |
| 1033739453 | John Frederick Endris | Pharmacist | 505 Colbrook Dr, Springfield, IL 62702-3384 | 2020-04-27 |
| 1770103889 | Seth Nelson | Pharmacist | 1150 N 5th St, Springfield, IL 62702-3800 | 2020-04-18 |
| 1952921074 | Edward John Oldfield | Pharmacist | 3441 Smythberry Ln Apt 7, Springfield, IL 62711-8210 | 2020-04-18 |
| 1255965240 | Matthew Sherriffs | Pharmacist | 2 Medical Center Dr Ste 204, Springfield, MA 01107-1271 | 2020-02-27 |
| 1023649134 | Kendra Yociss | Pharmacist | 201 E Madison St, Springfield, IL 62702-5131 | 2020-01-28 |
| 1861049397 | Laura A Kosiorek | Pharmacist | 242 Prentice St, Springfield, MA 01104-1525 | 2019-08-20 |
| 1144880048 | Akemi Nishida | Pharmacist | 520 Ethan Ct, Springfield, OR 97477-9407 | 2019-06-13 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on DR. GREGORY TYLER BOOTH.
| 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.