Active NPI
Michael Roth, DC
- Nutrition Chiropractor
- Ventura, CA
National Provider Identifier
1114175551
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Oct 20, 2021.
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- 16839
- Practice address
- 1787 Mesa Verde Ave
Suite 140
Ventura, CA 93003-6531 - Phone
- (805) 644-0461
- Fax
- (805) 644-1501
- NPI assigned
- Aug 27, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 16839 | CA | Primary |
Addresses
Primary practice location
1787 Mesa Verde Ave
Suite 140
Ventura, CA 93003-6531
Mailing address
1787 Mesa Verde Ave
Suite 140
Ventura, CA 93003-6531
Phone (805) 644-0461
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16839 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219795200000",
"number": "1114175551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1787 MESA VERDE AVE",
"address_2": "SUITE 140",
"city": "VENTURA",
"state": "CA",
"postal_code": "930036531",
"telephone_number": "805-644-0461",
"fax_number": "805-644-1501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1787 MESA VERDE AVE",
"address_2": "SUITE 140",
"city": "VENTURA",
"state": "CA",
"postal_code": "930036531",
"telephone_number": "805-644-0461",
"fax_number": "805-644-1501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "MICHAEL",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-08-27",
"last_updated": "2008-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "CA",
"license": "16839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.