Megan Roethle, CCP, RN

Primary specialty

PerfusionistTaxonomy code 242T00000X

Practice address

6308 8TH Ave
Kenosha, WI 53143-5031

Phone

(262) 355-5636

NPI assigned

Mar 14, 2017

Last updated

Apr 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Megan K Justman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1063953784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-355-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROETHLE",
        "first_name": "MEGAN",
        "credential": "CCP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "196715",
            "primary": false
        },
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "JUSTMAN",
            "middle_name": "K",
            "credential": "CCP, RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cassidy Rockey, PHARM D
• Tylor Rockwell
• Sarah Rodarte
• Rodrigo B Mata III, M.D., S.C.
• Rebecca J Rodriguez
• Shelley K Rogers, P.T.A.
• Lizabeth Rogge, LCSW,CSAC
• Roxane Rohani
• Romanak Vision Inc.
• Joseph Romanak

• Perfusionist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Perfusionist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.