Individual provider Active NPI

Joy Marie Roth, FNP-C

  • Family Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1164084190
Registry record updated Jun 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP001593 Issued in SD
Practice address
1417 S Cliff Ave Ste 401
Sioux Falls, SD 57105-1064
Phone
(605) 322-8920
NPI assigned
Jun 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP001593 SD Primary

Addresses

Primary practice location

1417 S Cliff Ave Ste 401
Sioux Falls, SD 57105-1064

Mailing address

1417 S Cliff Ave Ste 401
Sioux Falls, SD 57105-1064

Other practice location 1

1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone (605) 322-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20190912003140 SD Practitioner - Nurse Practitioner 1052640216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1417 S Cliff Ave
Suite 401
Sioux Falls, SD 57105-1064
Phone (605) 322-8920

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CP001593SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Aug 11, 2019 Accepting new patients
Avera McKennan CurrentSince Aug 11, 2019 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Past Accepting new patients

Locations

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

2100 S Marion Rd
Ste 300
Sioux Falls, SD 57106
Phone (605) 322-1300

6215 S Cliff Ave
Sioux Falls, SD 57108
Phone (605) 322-1530

1417 S Cliff Ave
Ste 401
Sioux Falls, SD 57105
Phone (605) 322-8920

Interoperability endpoints

  • Direct secure messaging: joy.roth@avera.sdhealthlink.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1561766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561766400000",
    "number": "1164084190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 S CLIFF AVE STE 401",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 S CLIFF AVE STE 401",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051064",
            "telephone_number": "605-322-8920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 S Cliff Ave",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051007",
            "country_code": "US",
            "telephone_number": "605-322-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JOY",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-29",
        "last_updated": "2019-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP001593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.