Philip a. Roth, Jr., MD/PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12141 Issued in AL

Legal business name

PHILIP A. ROTH, JR., MD/PC

Practice address

2089 Cecil Ashburn Dr SE
Suite 101
Huntsville, AL 35802-2567

Phone

(256) 533-3966

Fax

(256) 533-9652

NPI assigned

Sep 20, 2010

Organization subpart

No

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

Authorized official

Name

Philip A. Roth Jr., M.D.NPI 1710968383

Title

President

Phone

(256) 533-3966

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Philip Anthony Roth, MD

  • Family Medicine Physician
  • Huntsville, AL
  • NPI 1710968383
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1144538513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LOWELL DR SE",
            "address_2": "SUITE 103",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013754",
            "telephone_number": "256-535-5940",
            "fax_number": "256-535-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 CECIL ASHBURN DR SE",
            "address_2": "SUITE 101",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358022567",
            "telephone_number": "256-533-3966",
            "fax_number": "256-533-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP A. ROTH, JR., MD/PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-533-3966",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "12141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004036975",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080055438",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000085204",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "510-85204",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shandry L Peugeot, RN
• Serena Pewitt, LPC
• Pharmacy First LLC
• Ashley N Phelps, LICSW
• Phil'S Pills Incorporated
• Haley Phillippe, PHARM.D.
• Esther J Phillips-Embden, MA,CCC/SLP
• Aurelia Phillips
• Christopher Anthony Phillips, MSPT, RPT, CSCS
• Dixie Phillips, LMT

• Family Medicine Physician in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.

Verify at the official NPI Registry.