Individual provider Active NPI

Matthew J. Roth, D.C.

  • Chiropractor
  • Maineville, OH
National Provider Identifier
1275660136
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3396 Issued in OH
Practice address
3187 Western Row Rd
Suite 114
Maineville, OH 45039-8045
Phone
(513) 770-3434
Fax
(513) 229-5432
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3396 OH Primary

Addresses

Primary practice location

3187 Western Row Rd
Suite 114
Maineville, OH 45039-8045

Mailing address

3187 Western Row Rd
Suite 114
Maineville, OH 45039-8045
Phone (513) 770-3434

Other identifiers 2

IdentifierTypeStateIssuer
000000313242OtherOHANTHEM
2378252MedicaidOH

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
3396OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Damron Chiropractic & Wellness Chiropractor PastSince Jan 5, 2024 Accepting new patients

Organizations & group practices 1

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1275660136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3187 WESTERN ROW RD",
            "address_2": "SUITE 114",
            "city": "MAINEVILLE",
            "state": "OH",
            "postal_code": "450398045",
            "telephone_number": "513-770-3434",
            "fax_number": "513-229-5432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3187 WESTERN ROW RD",
            "address_2": "SUITE 114",
            "city": "MAINEVILLE",
            "state": "OH",
            "postal_code": "450398045",
            "telephone_number": "513-770-3434",
            "fax_number": "513-229-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MATTHEW",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000313242",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2378252",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maineville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.