MAGDELINE L BOOTH (NPI# 1811490139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811490139 |
| Entity Type | Individual |
| Full Name | MAGDELINE L BOOTH |
| Practice Address |
436 5th Avenue Kotzebue AK 99752 |
| Mailing Address |
Po Box 43 Kotzebue AK 99752-0043 |
| Practice Telephone | 9074427175 |
| Practice Fax Number | 9074427557 |
| Mailing Telephone | 9074427175 |
| Mailing Fax Number | 9074427557 |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 405300000X | Prevention Professional | 1045954 | AK | Other Service Providers |
| Street Address |
436 5TH AVENUE |
| City | KOTZEBUE |
| State | AK |
| Zip Code | 99752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295795342 | Linda Olson Bergum | Family Medicine | 436 5th Avenue, Kotzebue, AK 99752 | 2006-03-24 |
| 1063011005 | Walter Tanner | Nurse Practitioner | 436 5th Avenue, Kotzebue, AK 99752 | 2020-10-21 |
| 1710490701 | Denzel Mann | Pharmacist | 436 5th Avenue, Maniilaq Health Center, Kotzebue, AK 99752-9975 | 2017-11-13 |
| 1275089997 | Meagan Lincoln | Optometrist | 436 5th Avenue, Kotzebue, AK 99752 | 2016-09-01 |
| 1932486123 | Lisa C Shindler | Physician Assistant | 436 5th Avenue, Kotzebue, AK 99752 | 2011-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770103731 | Breanna Rosales | Counselor | 433 5 Th Ave, Kotzebue, AK 99752 | 2020-04-20 |
| 1679118814 | Verna Mariam Sherman | Case Manager/Care Coordinator | 733 2nd Ave., Kotzebue, AK 99752 | 2019-11-12 |
| 1568979565 | John Steven Ferraro | Counselor | 733 2'nd Ave, Kotzebue, AK 99752 | 2017-12-29 |
| 1528585494 | Guardian Flight LLC | Ambulance | Teacher Housing Apt # 18 Lagoon Street, Kotzebue, AK 99752 | 2017-08-23 |
| 1366998114 | Alaskans Changing Together, Inc. | Counselor | 241 5th Ave, Kotzebue, AK 99752 | 2016-08-31 |
| 1205236692 | Kimberly Baldwin | Dental Therapist | 436 5th Ave Ted Stevens Way, Kotzebue, AK 99752 | 2014-09-04 |
| 1811309040 | Sylvia Michelle Windham | Advanced Practice Midwife | 436 5th Avenue and Ted Stevens Way, Kotzebue, AK 99752 | 2014-05-22 |
| 1881941193 | Belynda M. Gregg | Case Manager/Care Coordinator | 256 2nd Ave, F.r. Ferguson Building, Kotzebue, AK 99752 | 2012-08-07 |
| 1689932436 | Srikanth Rao Dakoji | Family Medicine | 479 Mission St, Apt C8, Kotzebue, AK 99752 | 2012-04-30 |
| 1932434792 | Joseph E Copeland | Family Medicine | Maniilaq Healh Center, Box 43, Kotzebue, AK 99752 | 2009-10-13 |
| Find all providers in zip 99752 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780186973 | Chrishawna Yazzie | Prevention Professional | 333 Shore Ave, Kotzebue, AK 99752-9800 | 2018-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568995231 | Michele Lewis | Prevention Professional | 5955 Zeamer Ave, Anchorage, AK 99506-3702 | 2017-04-09 |
| 1366980534 | Laura Lee Moscatello | Prevention Professional | 541 W 36th Ave, Anchorage, AK 99503-5804 | 2017-02-07 |
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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.