{
  "npi": "1811460082",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2026-03-24",
    "credential": "PT, DPT, ATC, MS",
    "enumeration_date": "2019-01-09",
    "first_name": "MICHAEL",
    "last_name": "BOOTH",
    "last_updated": "2026-03-24",
    "middle_name": "KENT",
    "name_prefix": "Dr.",
    "sex": "M",
    "sole_proprietor": "YES",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "19 SHOEMAKER DR",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "SWEDESBORO",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "080851256",
      "state": "NJ",
      "telephone_number": "609-805-7668"
    },
    {
      "address_1": "484 CONCHESTER HWY",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "ASTON",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "610-494-1206",
      "postal_code": "190143129",
      "state": "PA",
      "telephone_number": "610-494-4802"
    }
  ],
  "taxonomies": [
    {
      "code": "2255A2300X",
      "desc": "Specialist/Technologist, Athletic Trainer",
      "license": "25MT00302200",
      "primary": false,
      "state": "NJ",
      "taxonomy_group": ""
    },
    {
      "code": "225100000X",
      "desc": "Physical Therapist",
      "license": "PT031441",
      "primary": true,
      "state": "PA",
      "taxonomy_group": ""
    },
    {
      "code": "225100000X",
      "desc": "Physical Therapist",
      "license": "40QA02349300",
      "primary": false,
      "state": "NJ",
      "taxonomy_group": ""
    },
    {
      "code": "2255A2300X",
      "desc": "Specialist/Technologist, Athletic Trainer",
      "license": "RT007664",
      "primary": false,
      "state": "PA",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "65",
        "medicare_type": "Physical Therapist in Private Practice"
      }
    ]
  }
}