Roth Family Medicine and Mental Health

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ROTH FAMILY MEDICINE AND MENTAL HEALTH

Practice address

2890 Ridgeview LN
Pocatello, ID 83204-7291

Phone

(510) 502-9455

NPI assigned

Mar 21, 2026

Organization subpart

No

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

Authorized official

Name

Mr. Kyle Abraham Roth, FNPNPI 1659238822

Title

Nurse Practitioner

Phone

(510) 502-9455

Specialties & licenses 1

Addresses

Tax ID family

Roth Family Medicine and Mental Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Roth Family Medicine and Mental Health

  • Nurse Practitioner
  • Pocatello, ID
  • NPI 1144168881
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle A Roth, NP

  • Family Nurse Practitioner
  • Pocatello, ID
  • NPI 1659238822
  NPD Authorized official

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

{
    "created_epoch": "1774051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774051200000",
    "number": "1134077357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 RIDGEVIEW LN",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832047291",
            "telephone_number": "510-502-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 RIDGEVIEW LN",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832047291",
            "telephone_number": "510-502-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROTH FAMILY MEDICINE AND MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-21",
        "last_updated": "2026-03-21",
        "certification_date": "2026-03-21",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "ABRAHAM",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "510-502-9455",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Root and Rise Pediatric Therapy LLC
• Benson S Roper, CRNA
• Rose Center for Healing
• Cassidy Michelle Roske, LPC
• Theresa L. Ross, PHD
• Roth Family Medicine and Mental Health
• Kathryn Jill Roth, FNP-C
• Kyle A Roth, NP
• Elizabeth Lassen Rowden, MS, RDN, LD
• Nathan T. Rowe, NP-C

• Clinic/Center in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2026; 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.