Individual provider Active NPI

Courtney Elizabeth Roth

  • Physical Therapist
  • Stevens Point, WI
National Provider Identifier
1093508657
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17223-24 Issued in WI
Practice address
5501 Em Copps Dr
Stevens Point, WI 54482-8843
Phone
(715) 997-9816
NPI assigned
May 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 17223-24 WI Primary

Addresses

Primary practice location

5501 Em Copps Dr
Stevens Point, WI 54482-8843

Mailing address

500 Vincent St
Stevens Point, WI 54481-1842

Other practice location 1

500 Vincent St
Stevens Point, WI 54481-1842
Phone (715) 344-0701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250623001073 WI Practitioner - Physical Therapist in Private Practice 1052823440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Centers of Wisconsin S CGroup PAC ID 4981679552, 58 clinicians

Practice addresses (Care Compare)

5501 Em Copps Dr
Stevens Point, WI 54482-8843
Phone (715) 344-0701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17223-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Centers of Wisconsin S C Physical Therapist Current Accepting new patients
Orthopaedic Centers of Wisconsin S C Physical Therapist CurrentSince Jul 15, 2025 Accepting new patients
Orthopaedic Centers of Wisconsin S C Physical Therapist CurrentSince Jul 15, 2025 Accepting new patients
Orthopaedic Centers of Wisconsin S C Past Accepting new patients

Locations

500 Vincent St
Stevens Point, WI 54481
Phone (715) 341-7920

5501 Em Copps Dr
Stevens Point, WI 54482
Phone (715) 344-0701

3901 Stewart Ave
Wausau, WI 54401
Phone (715) 841-0002

Interoperability endpoints

  • Direct secure messaging: courtney.roth@spo.directbygreenway.com

Organizations & group practices 5

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": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1093508657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 VINCENT ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 EM COPPS DR",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544828843",
            "telephone_number": "715-997-9816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Vincent St",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544811842",
            "country_code": "US",
            "telephone_number": "715-344-0701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "COURTNEY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "17223-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.