JACQUELINE RENEE BOOTH (MD) – Plastic Surgery within the Head & Neck (Otolaryngology) Physician, NPI 1083143671
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
288 OTOLARYNGOLOGY in TN
Provider Addresses for JACQUELINE RENEE BOOTH (MD)
800 OAK RIDGE TPKE STE C100
OAK RIDGE, TN 378306927
Phone: (865) 483-2288
Fax: (865) 482-4400
Type: Location
1855 Tanner Way Ste 130
Harriman, TN 377488332
Phone: (865) 882-1600
Fax: (865) 285-9684
Type: Location
109 Independence Ln Ste 500
LA Follette, TN 377663040
Phone: (423) 562-9744
Fax: (423) 544-1862
Type: Location
Augusta University Medical Center, 1120, 15th Street, Augusta, Richmond County, Georgia, 30912, United States
AUGUSTA, GA 309120004
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $24.
Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.
Last reported payment date: 2023-08-23 • Largest payer in this snapshot: Galderma Laboratories, L.P. ($24).
Total Amount
$24
General + Research + Ownership
Payments
1
Total payment records
General Amount
$24
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Galderma Laboratories, L.P. | $24 |
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: 2025-07-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220405002181 | I | Otolaryngology | AL | TBD |
| I20240206004164 | I | Otolaryngology | NY | TBD |
| I20240729001459 | I | Otolaryngology | GA | TBD |
| I20250723003493 | I | Otolaryngology | TN | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 37830)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Physician Assistant | TN | |
| - | GA | |
| - | GA | |
| D E R M A T O L O G Y | GA | |
| Nurse Practitioner | GA |
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