NPIMap

Organization Active NPI

Brent a Roth DC Inc

  • Chiropractor
  • Hicksville, OH
National Provider Identifier
1033316419
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
719 Issued in OH
Legal business name
BRENT A ROTH DC INC
Practice address
501 W High St
Hicksville, OH 43526-1083
Phone
(419) 542-8247
Fax
(419) 542-6726
NPI assigned
Jun 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Brent A Roth, DCNPI 1952318230
Title
President
Phone
(419) 542-8247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 719 OH Primary

Addresses

Primary practice location

501 W High St
Hicksville, OH 43526-1083

Mailing address

501 W High St
Hicksville, OH 43526-1083
Phone (419) 542-8247

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033316419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W HIGH ST",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261083",
            "telephone_number": "419-542-8247",
            "fax_number": "419-542-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W HIGH ST",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261083",
            "telephone_number": "419-542-8247",
            "fax_number": "419-542-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT A ROTH DC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-542-8247",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.