Keley J Booth (NPI# 1558387696, PAC ID# 7214930064) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERVENTIONAL PAIN MANAGEMENT.
| Nation Provider ID (NPI) | 1558387696 |
| PAC ID by PECOS | 7214930064 |
| Professional Enrollment ID | I20060916000004 |
| Full Name | Keley J Booth |
| Organization Legal Name | ELITE PAIN AND HEALTH PC |
| Address |
11401 S Western Ave Oklahoma City OK 73170-5819 |
| Phone Number | 8007811220 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE |
| Graduation Year | 2002 |
| Primary Specialty | INTERVENTIONAL PAIN MANAGEMENT |
| Secondary Specialties | ANESTHESIOLOGY |
| Group Practice PAC ID | 5193017085 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370002 | ALLIANCEHEALTH WOODWARD |
| 370220 | ONECORE HEALTH |
| 370029 | ALLIANCEHEALTH CLINTON |
| Address | Phone | Organization |
|---|---|---|
| 11401 S Western Ave, Oklahoma City, OK 73170-5819 | 8007811220 | ELITE PAIN AND HEALTH PC |
| Organization Legal Name | ELITE PAIN AND HEALTH PC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard D Watkins | Nurse Practitioner | Elite Pain and Health PC | 13100 N Western Ave, Suite 200, Oklahoma City, OK 73114-1430 |
| Jason J Jackson | Physical Medicine and Rehabilitation | Elite Pain and Health PC | 13100 N Western Ave, Suite 200, Oklahoma City, OK 73114-1430 |
| Tiffany Ogden | Nurse Practitioner | Elite Pain and Health PC | 13100 N Western Ave, Suite 200, Oklahoma City, OK 73114-1430 |
| Tammy Lynn Williams | Nurse Practitioner | Elite Pain and Health PC | 13100 N Western Ave, Suite 200, Oklahoma City, OK 73114-1430 |
| Street Address |
11401 S WESTERN AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip | 73170-5819 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michelle E Webster | Obstetrics/gynecology | Surgical Assistants PC | 11401 S Western Ave, Oklahoma City, OK 73170-5819 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roy Slootheer | Nurse Practitioner | Immediate Care of Oklahoma LLC | 11808 S May Ave, Oklahoma City, OK 73170-2560 |
| Richard D Brock | Family Medicine | Immediate Care of Oklahoma LLC | 11808 S May Ave, Oklahoma City, OK 73170-2560 |
| Kyle E Hollingsworth | Physician Assistant | Immediate Care of Oklahoma LLC | 11808 S May Ave, Oklahoma City, OK 73170-2560 |
| Amanda A Bodine | Physician Assistant | Immediate Care of Oklahoma LLC | 11808 S May Ave, Oklahoma City, OK 73170-2560 |
| Cassie Mcintosh | Nurse Practitioner | Immediate Care of Oklahoma LLC | 11808 S May Ave, Oklahoma City, OK 73170-2560 |
| Ryan D Wilson | Emergency Medicine | Immediate Care of Oklahoma LLC | 11808 S May Ave, Oklahoma City, OK 73170-2560 |
| Cassandra M Gentry | Physician Assistant | Immediate Care of Oklahoma LLC | 11808 S May Ave, Oklahoma City, OK 73170-2560 |
| Jessi M Siler | Physician Assistant | Immediate Care of Oklahoma LLC | 11808 S May Ave, Oklahoma City, OK 73170-2560 |
| Brandon S. Drabek | Family Practice | Immediate Care of Oklahoma LLC | 11808 S May Ave, Oklahoma City, OK 73170-2560 |
| Jeremy George Tanner | Nurse Practitioner | Immediate Care of Oklahoma LLC | 11808 S May Ave, Oklahoma City, OK 73170-2560 |
| Find all physicians in zip 73170 | |||
| City | OKLAHOMA CITY |
| Zip Code | 73170 |
| Specialty | INTERVENTIONAL PAIN MANAGEMENT |
| City + Specialty | OKLAHOMA CITY + INTERVENTIONAL PAIN MANAGEMENT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.