Individual provider Active NPI

Lindsey Ann Roth, NP

  • Family Nurse Practitioner
  • Grand Blanc, MI
National Provider Identifier
1053662262
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704246129 Issued in MI
Practice address
8483 Holly Rd
Grand Blanc, MI 48439-1840
Phone
(810) 694-7955
NPI assigned
Sep 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704246129 MI
Family Nurse Practitioner 363LF0000X 4704246129 MI Primary

Addresses

Primary practice location

8483 Holly Rd
Grand Blanc, MI 48439-1840

Mailing address

3495 S Center Rd
Burton, MI 48519-1455
Phone (810) 424-2011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121201000067 MI Practitioner - Nurse Practitioner 2264684026 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704246129MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesee Health System Current Accepting new patients
Genesee Health System Family CurrentSince Mar 15, 2016 Accepting new patients
Genesee Health System Nurse Practitioner CurrentSince Mar 15, 2016 Accepting new patients
E Saeed MD PC PastSince Jul 1, 2003 Accepting new patients

Locations

422 W 4th Ave
Flint, MI 48503
Phone (810) 496-5500

420 W 5th Ave
Flint, MI 48503
Phone (810) 257-3724

2298 S Center Rd
Flint, MI 48519
Phone (810) 496-5777

1402 S Saginaw St
Flint, MI 48503
Phone (810) 496-4955

1040 W Bristol Rd
Flint, MI 48507
Phone (810) 257-3724

725 Mason St
Flint, MI 48503
Phone (810) 257-3736

Interoperability endpoints

  • Direct secure messaging: lindsey.rothfnpbc.p1@direct.gchc.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1053662262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455",
            "telephone_number": "810-424-2011",
            "fax_number": "810-249-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8483 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391840",
            "telephone_number": "810-694-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "LINDSEY",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704246129",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704246129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.