Active NPI
Danny Joe Roth, CRNA, APN
- Certified Registered Nurse Anesthetist
- Fairbanks, AK
National Provider Identifier
1164504403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 384
- Practice address
- 1650 Cowles St
Fairbanks, AK 99701-5998 - Phone
- (907) 388-6852
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 12213 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | 384 | AK | Primary |
Addresses
Primary practice location
1650 Cowles St
Fairbanks, AK 99701-5998
Mailing address
2460 Topeka Drive
North Pole, AK 99705-2460
Phone (423) 315-6338
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (865) 546-8040
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 384 | AK | MD | Dentist |
| 12213 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of Tennessee, P.C. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| American Anesthesiology of Tennessee, P.C. | Current | Accepting new patients | |
| Fairbanks Anesthesia Inc. | Past | Accepting new patients |
Locations
2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620
9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Knoxville, TN
- NPI 1609822998
-
- Certified Registered Nurse Anesthetist
- Knoxville, TN
- NPI 1245279777
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Fairbanks, AK
- NPI 1629098140
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1164504403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2460 TOPEKA DRIVE",
"city": "NORTH POLE",
"state": "AK",
"postal_code": "997052460",
"telephone_number": "423-315-6338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 COWLES ST",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015998",
"telephone_number": "907-388-6852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "DANNY",
"middle_name": "JOE",
"name_prefix": "Mr.",
"credential": "CRNA, APN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "12213",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AK",
"license": "384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.