MR. JOHN DAVID BOTERO (NP-C) – Family Nurse Practitioner, NPI 1083921274

MR. JOHN DAVID BOTERO (NP-C) is a healthcare provider. based in Lawrenceville, Georgia. specializing in Family Nurse Practitioner. They hold the professional credentials NP-C. They hold a License No. RN207415 (GA). The NPI Number for MR. JOHN DAVID BOTERO (NP-C) is 1083921274

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
MR. JOHN DAVID BOTERO (NP-C)
NPI
1083921274
Phone
(770) 963-8030
Address
631 PROFESSIONAL DR STE 450
Enumeration Date
9 September 2010
Last Update Date
9 September 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7063567800
Graduation Year
2009 (17 years ago)
PAC ID
9436308418
Group Practice PAC ID
0143592469
Professional Enrollment ID
I20121008000276
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

Provider Addresses for MR. JOHN DAVID BOTERO (NP-C)

  • 631 PROFESSIONAL DR STE 450

    LAWRENCEVILLE, GA 300463370

    Phone: (770) 963-8030

    Fax: (770) 339-9577

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-10-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20121008000276INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making105102$0
99285Emergency department visit with high level of medical decision making5756$0
99283Emergency department visit with low level of medical decision making1818$0
View full utilization report →

Insurance plans in this area (ZIP 30046)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0143592469View full group profile

Reviews

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Frequently asked questions

What federal number belongs to MR. JOHN DAVID BOTERO (NP-C)?
The federal identifier for MR. JOHN DAVID BOTERO (NP-C) is NPI 1083921274.
Is MR. JOHN DAVID BOTERO (NP-C) currently active in the NPI registry?
CMS-published data lists MR. JOHN DAVID BOTERO (NP-C) as an active registrant.
What field does MR. JOHN DAVID BOTERO (NP-C) work in?
You can think of MR. JOHN DAVID BOTERO (NP-C) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does MR. JOHN DAVID BOTERO (NP-C) practice in Georgia?
You will see Lawrenceville, Georgia on file for MR. JOHN DAVID BOTERO (NP-C) alongside any extra practice locations.
Is MR. JOHN DAVID BOTERO (NP-C) a real provider?
This page reflects official NPPES data for NPI 1083921274. Always confirm identity and privileges with the practice and licensing boards.

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