George J Roth, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-97 Issued in ID

Practice address

1210 NW 16TH St
Fruitland, ID 83619-2202

Phone

(208) 452-8600

Fax

(208) 452-8601

NPI assigned

May 17, 2007

Last updated

Sep 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

Practice roles

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

• Physician's Primary Care Center, Inc.

  • Basic Emergency Medical Technician
  • Weiser, ID
  • NPI 1922291384
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1073720124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 NW 16TH ST",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192202",
            "telephone_number": "208-452-8600",
            "fax_number": "208-452-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "GEORGE",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-97",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanna Rae Rendo, NP-C
• RH Counseling and Therapy LLC
• Sierra Marie Riley
• Riverside Orthopedic Clinic
• Tyler Robb, DDS
• Rxpad Medical
• Saint Alphonsus Medical Center- Ontario Inc (Saint Alphonsus Medical Group Fruitland Health Plaza)
• Kimberly Schultheiss, RPH
• Lionel Alexander Segura
• Sherin Siby

• Physician Assistant in Fruitland, ID
• Providers in Fruitland, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.