Active NPI
Calvin A Roseth, MD
- Internal Medicine Physician
- Watertown, SD
National Provider Identifier
1215916739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2698
- Practice address
- 901 4TH St NW
Watertown, SD 57201-1558 - Phone
- (605) 886-8471
- Fax
- (605) 886-9317
- NPI assigned
- Jan 12, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2698 | SD | Primary |
Addresses
Primary practice location
901 4TH St NW
Watertown, SD 57201-1558
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6001962 | Medicaid | SD |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2698 | SD | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649635200000",
"number": "1215916739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 4TH ST NW",
"city": "WATERTOWN",
"state": "SD",
"postal_code": "572011558",
"telephone_number": "605-886-8471",
"fax_number": "605-886-9317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSETH",
"first_name": "CALVIN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-12",
"last_updated": "2022-04-11",
"certification_date": "2022-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SD",
"license": "2698",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6001962",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watertown, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.