Active NPI
Christine Sue Roth, CRNA
- Certified Registered Nurse Anesthetist
- Decorah, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- D102488
- Practice address
- 901 Montgomery St
Decorah, IA 52101-2325 - Phone
- (563) 382-2911
- Fax
- (563) 387-3102
- NPI assigned
- May 23, 2006
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | D102488 | IA | Primary |
Addresses
Primary practice location
901 Montgomery St
Decorah, IA 52101-2325
Mailing address
901 Montgomery St
Decorah, IA 52101-2325
Phone (563) 382-2911
Other practice location 1
744 S Webster Ave
Green Bay, WI 54301-3504
Phone (920) 433-3605
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114972858 | Medicaid | IA |
Other names 1
- Christine Sue Sims
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA, WI
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.7 of 100
- Quality
- 91.14
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.5
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8233 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Divine Savior Healthcare, Inc. | Current | Accepting new patients | |
| Mercy Clinton Anesthesia Group LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Tomah Memorial Hospital Inc | Current | Accepting new patients | |
| Divine Savior Healthcare, Inc. | Current | Accepting new patients | |
| Richland Hospital | Current | Accepting new patients | |
| Richland Hospital | Current | Accepting new patients | |
| Vituity-Wisconsin Anesthesia SC | Current | Accepting new patients | |
| Vituity-Wisconsin Anesthesia SC | Current | Accepting new patients | |
| Tomah Memorial Hospital Inc | Current | Accepting new patients | |
| Knoxville Area Anesthesia Services | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Bloomfield Anesthetists | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1410 N 4th St
Clinton, IA 52732
Phone (563) 244-5555
29980 Network Pl
Chicago, IL 60673
400 10th St E
Waconia, MN 55387
9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000
2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598
333 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161
501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181
Organizations & group practices 12
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.
-
dba Aspirus Divine Savior Hospital
- General Acute Care Hospital
- Portage, WI
- NPI 1124083894
-
- Anesthesiology Physician
- Clinton, IA
- NPI 1184962862
Nurse Anesthetist, Certified Registered
-
- Critical Access Hospital
- Richland Center, WI
- NPI 1659301273
-
- Anesthesiology Physician
- Pleasant Prairie, WI
- NPI 1821831975
-
dba Vernon Health
- Critical Access Hospital
- Viroqua, WI
- NPI 1497750921
-
dba Aspirus Portage Clinic
- Rural Health Clinic/Center
- Portage, WI
- NPI 1386154417
-
dba Community Pharmacy at The Richland Hospital
- Community/Retail Pharmacy
- Richland Center, WI
- NPI 1558127480
-
dba Tomah Memorial Hospital
- Medicare Defined Swing Bed Hospital Unit
- Tomah, WI
- NPI 1205978046
-
- Anesthesiology Physician
- Milwaukee, WI
- NPI 1801620067
-
- Certified Registered Nurse Anesthetist
- Bloomfield, IA
- NPI 1811091390
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Knoxville, IA
- NPI 1104089275
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Aspirus Divine Savior Hospital
- General Acute Care Hospital
- Portage, WI
- NPI 1124083894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1114972858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 MONTGOMERY ST",
"city": "DECORAH",
"state": "IA",
"postal_code": "521012325",
"telephone_number": "563-382-2911",
"fax_number": "563-387-3102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 MONTGOMERY ST",
"city": "DECORAH",
"state": "IA",
"postal_code": "521012325",
"telephone_number": "563-382-2911",
"fax_number": "563-387-3102"
}
],
"practiceLocations": [
{
"address_1": "744 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013504",
"country_code": "US",
"telephone_number": "920-433-3605",
"fax_number": "920-433-3589",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROTH",
"first_name": "CHRISTINE",
"middle_name": "SUE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-23",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IA",
"license": "D102488",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1114972858",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTINE",
"last_name": "SIMS",
"middle_name": "SUE",
"credential": "CRNA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Decorah, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.