FRED BOOTHBY CNP
NPI 1962483271
Nurse Practitioner in Allegan, MI

Q: What is Fred Boothby's NPI number?

The NPI number for Fred Boothby is 1962483271. It was assigned to this individual provider in the NPPES registry on November 14, 2005.

Q: What is Fred Boothby's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Fred Boothby was last updated on January 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 14, 2005

3285 122ND AVE, P.O. DRAWER 130, ALLEGAN, MI 49010(269) 673-6617(269) 673-2738 Get Directions Write a Review

NPPES record last updated: January 18, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Fred Boothby Cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FRED BOOTHBY CNP (NPI 1962483271) is an individual nurse practitioner in Allegan, Michigan, licensed in Michigan (4704142595) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1962483271

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameFRED BOOTHBYCredential: CNP

Location Address3285 122ND AVE, P.O. DRAWER 130Allegan, MI 49010-9511

Mailing Address3285 122nd Ave, P.o. Drawer 130Allegan, MI 49010-9511 · (269) 673-6617 · Fax (269) 673-2738

Phone(269) 673-6617

Fax(269) 673-2738

Sole ProprietorNo

Enumeration DateNovember 14, 2005

Last NPPES UpdateJanuary 18, 2008

✔ NPI 1962483271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MI · 4704142595

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

3285 122ND AVE, Allegan, MI 49010

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Other Identifiers 4

Other5008704740MI · Bcbs

Medicare UPINS94653

Medicare ID-Type UnspecifiedOP16140

Medicaid4699274MI

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TERRI L DOEZEMA LLP

Psychologist

3285 122ND AVE, P.O. DRAWER 130
ALLEGAN, MI 49010

Allegan County (269) 673-6617

MS. KIMBERLY RENEE BOUCHARD RN, AEMT

Registered Nurse (Psychiatric/Mental Health)

3285 122ND AVE
ALLEGAN, MI 49010

Allegan County (269) 673-6617

LAURISSA STAWICKI LBSW

Social Worker

3285 122ND AVE
ALLEGAN, MI 49010

Allegan County (269) 673-6617

MRS. NANCY ANNE BURCHARDT

Registered Nurse

3285 122ND AVE, PO DRAWER 130
ALLEGAN, MI 49010

Allegan County (800) 795-6617

CHERI JO SCHROEDER LLMSW

Case Manager/Care Coordinator

3285 122ND AVE
ALLEGAN, MI 49010

Allegan County (269) 673-6617

KRISTIE LYNN PAGEL-COMPAGNER LMSW

Social Worker

3285 122ND AVE
ALLEGAN, MI 49010

Allegan County (269) 673-6617

ROBERT WILLIAM GRIFFITH RN

Registered Nurse (Psychiatric/Mental Health)

3285 122ND AVE
ALLEGAN, MI 49010

Allegan County (269) 317-3909

CATHY MOORED

Specialist

3285 122ND AVE
ALLEGAN, MI 49010

Allegan County (269) 673-6617

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fred Boothby's NPI number?

The NPI number for Fred Boothby is 1962483271. It was assigned to this individual provider in the NPPES registry on November 14, 2005.

Where is Fred Boothby located?

Fred Boothby practices at 3285 122nd Ave P.O. Drawer 130, Allegan, MI 49010. The listed phone number is (269) 673-6617.

What is Fred Boothby's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Fred Boothby was last updated on January 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.