Individual provider Active NPI

Melia Roth, MSNED, APRN, FNP-C

  • Family Nurse Practitioner
  • Youngstown, OH
National Provider Identifier
1144084831
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0035850 Issued in OH
Practice address
5100 Belmont Ave Ste 5
Youngstown, OH 44505-1043
Phone
(330) 333-6404
Fax
(330) 545-5919
NPI assigned
Feb 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0035850 OH
Family Nurse Practitioner 363LF0000X 0035850 OH Primary

Addresses

Primary practice location

5100 Belmont Ave Ste 5
Youngstown, OH 44505-1043

Mailing address

2476 Edgewater Dr
Cortland, OH 44410-9642
Phone (330) 883-4619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241011003687 OH Practitioner - Nurse Practitioner 5395277560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0035850OHMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1144084831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2476 EDGEWATER DR",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444109642",
            "telephone_number": "330-883-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 BELMONT AVE STE 5",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051043",
            "telephone_number": "330-333-6404",
            "fax_number": "330-545-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MELIA",
        "credential": "MSNED, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0035850",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0035850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.