Individual provider

CARRIE JEAN BOOTS, N.P.

CMS NPPES lists CARRIE JEAN BOOTS as an individual provider record with NPI 1003012352. The current record reports a primary practice location in FORT WAYNE, IN and primary taxonomy code 363LF0000X.

NPI 1003012352Record type Type 1Primary taxonomy 363LF0000X

Type 1 NPIs identify individual healthcare providers. How to read this profile

01

Practice locations

  1. Primary practice location
    7910 W JEFFERSON BLVD STE 108FORT WAYNE, IN 468044159

Only source-designated practice locations are shown here. Mailing addresses are not presented as practice locations.

02

Taxonomy information

  • 363L00000XAdditional reported taxonomy
  • 363LA2200XAdditional reported taxonomy
  • 363LF0000XPrimary reported taxonomy

Taxonomy codes describe provider classifications reported to NPPES. Repeated identical codes are shown once, with primary-reported status preserved. They are not licenses, certifications, quality measures, or NPIFolio specialty labels. Read the taxonomy methodology.

03

NPI record information

NPI status
Enumerated in NPPES
Enumeration date
June 25, 2007

An NPI is a federal identifier. Enumeration and lifecycle information does not establish medical-license status, current practice, disciplinary history, provider quality, or whether a provider is accepting patients.