Kenneth Michael Rothman, D,ED.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY2560 Issued in FL

Practice address

1061 E Indiantown Rd
Suite 311
Jupiter, FL 33477-5104

Phone

(561) 575-0323

Fax

(561) 575-0323

NPI assigned

Jul 28, 2005

Last updated

Aug 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186617600000",
    "number": "1134129307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 E INDIANTOWN RD",
            "address_2": "SUITE 311",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334775104",
            "telephone_number": "561-575-0323",
            "fax_number": "561-575-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 E INDIANTOWN RD",
            "address_2": "SUITE 311",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334775104",
            "telephone_number": "561-575-0323",
            "fax_number": "561-575-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHMAN",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D,ED.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2007-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2560",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "FL",
            "license": "PY2560",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "73738",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matteo Rosselli, DO
• Willow B Rossi, MS, OTR/L
• Eileen Marie Rostock, D.D.S.
• Matt Harris Rostock, D.D.S.
• Judith S Rothenberg, MSW, LCSW
• Taylor Rotz, OD
• David Magdy Roufaiel, M.D.
• Thomas R Rowe, M.D.
• Royal Palm Beach Medical, Inc
• Royal Palm Beach Rehab, Corp (Action Physical Therapy)

• Clinical Psychologist in Jupiter, FL
• Providers in Jupiter, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; 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.