Look up the most recent NPI and PECOS records

Jillian Kay Booth

Counselor

Behavioral Health & Social Service Providers

PECOS Enrollment

This provider is enrolled in PECOS as JILLIAN BOOTH.

Based on the most recent information from CMS, provider Jillian Kay Booth is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:51 AM.

Profile Details

Provider ID
1265147185
Provider Type
Individual
Full Name
Booth, Jillian Kay
Gender
Female

Sole Proprietor
No
Enumeration Date
1/16/2023
Last Updated
1/16/2023

Contact Information

Practice Location

10845 Harney St, Omaha, NE 68154-2639

(402) 327-1197

Unlisted Fax

Mailing Location

1648 S 152nd St, Omaha, NE 68144-5123

(402) 650-4050

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer

Jillian Kay Booth

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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