Stephanie A. Roth, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

245 Issued in AR

Practice address

703 W Main St
Russellville, AR 72801-3616

Phone

(479) 647-6443

NPI assigned

Jan 9, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• River Valley Foot & Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Russellville, AR
  • NPI 1750663571
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1235314147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10424",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728120424",
            "telephone_number": "479-968-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013616",
            "telephone_number": "479-647-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "STEPHANIE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AR",
            "license": "245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose & Wells, Inc. (Legacy Lodge Nursing Home)
• Rose Drug of Russellville Inc
• Rose Drug of Russellville, Inc
• Rose Drug of Russellville, Inc
• Kelsey Marissa Ross
• Mittie Rowland
• Kenneth Roy, M.A. LAC
• Rpi Rehab Operations, LLC
• Rpi Sleep Complete LLC (Sleep Complete)
• Gayle L Ruffiner, RPT

• Foot & Ankle Surgery Podiatrist in Russellville, AR
• Providers in Russellville, AR by specialty
• Foot & Ankle Surgery Podiatrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.