Individual provider Active NPI

Suzanne O'Rourke Rothberg, WHNP

  • Women's Health Nurse Practitioner
  • West Valley City, UT
National Provider Identifier
1205140043
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
6592021-4408 Issued in UT
Practice address
1906 W 3600 S
West Valley City, UT 84119-4715
Phone
(801) 973-9675
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 6592021-4408 UT Primary

Addresses

Primary practice location

1906 W 3600 S
West Valley City, UT 84119-4715

Mailing address

1115 E 200 S
Salt Lake City, UT 84102-2503
Phone (218) 230-4108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6592021-4408UTMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Association of Utah Past Accepting new patients
Planned Parenthood Association of Utah Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1205140043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 E 200 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022503",
            "telephone_number": "218-230-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 W 3600 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841194715",
            "telephone_number": "801-973-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBERG",
        "first_name": "SUZANNE",
        "middle_name": "O'ROURKE",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "UT",
            "license": "6592021-4408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.