MEDICARE: PATRICK BOOTH DNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0200X	Critical Care Medicine Registered Nurse	R231254	MD
2	367500000X	Certified Registered Nurse Anesthetist	0024192693	VA
3	367500000X	Certified Registered Nurse Anesthetist	R231254	MD

General Provider Information

NPI Number	:	1306434766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK BOOTH DNP

Provider Business Mailing Address
First Line	:	3816 ARCHER PL
Second Line	:
City	:	KENSINGTON
State	:	MD
Zip	:	20895-1601
Country	:	US
Telephone Number	:	302-528-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 HOSPITAL DR
Second Line	:
City	:	CHEVERLY
State	:	MD
Zip	:	20785-1189
Country	:	US
Telephone Number	:	301-618-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2020
Last Update Date	:	12/04/2025

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