NPIMap

Organization Active NPI

Robert Roth MD a Professional

Doing business as Box Canyon Primary Care

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1023287695
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
8797 Issued in NV
Legal business name
ROBERT ROTH MD A PROFESSIONAL
Doing business as
Box Canyon Primary Care
Practice address
2647 Box Canyon Dr
Las Vegas, NV 89128-0450
Phone
(702) 363-5575
Fax
(702) 646-1727
NPI assigned
Feb 27, 2008
Last updated
Aug 31, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashley Nuss, CPC
Title
Biller/Coder
Phone
(702) 363-5575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 8797 NV Primary

Addresses

Primary practice location

2647 Box Canyon Dr
Las Vegas, NV 89128-0450

Mailing address

2647 Box Canyon Dr
Las Vegas, NV 89128-0450
Phone (702) 363-5575

Other identifiers 1

IdentifierTypeStateIssuer
V101524OtherNVMEDICARE GROUP #

Other names 1

  • BOX CANYON PRIMARY CARE Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1023287695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 BOX CANYON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280450",
            "telephone_number": "702-363-5575",
            "fax_number": "702-646-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 BOX CANYON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280450",
            "telephone_number": "702-363-5575",
            "fax_number": "702-646-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT ROTH MD A PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "NUSS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "BILLER/CODER",
        "authorized_official_telephone_number": "702-363-5575",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NV",
            "license": "8797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "V101524",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BOX CANYON PRIMARY CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BOX CANYON PRIMARY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.