Individual provider Active NPI

Barbara Jean Roth

  • Psychiatric/Mental Health Nurse Practitioner
  • Hiawatha, IA
National Provider Identifier
1306627443
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G176305 Issued in IA
Practice address
1340 Blairs Ferry Rd
Hiawatha, IA 52233-1900
Phone
(319) 398-6575
NPI assigned
Oct 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G176305 IA Primary

Addresses

Primary practice location

1340 Blairs Ferry Rd
Hiawatha, IA 52233-1900

Mailing address

1340 Blairs Ferry Rd
Hiawatha, IA 52233-1900
Phone (319) 398-6575

Other practice location 1

1340 Blairs Ferry Rd
Hiawatha, IA 52233-1900
Phone (319) 398-6575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231207001173 IA Practitioner - Nurse Practitioner 0749639409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

1340 Blairs Ferry Rd
Unit a
Hiawatha, IA 52233-1900
Phone (319) 398-6575

701 10TH St SE
Cedar Rapids, IA 52403-1251

701 10TH St SE J Edward Lundy
Mercy Pediatric Clinic
Cedar Rapids, IA 52403-1251
Phone (319) 832-2328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G176305IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Nov 1, 2023 Accepting new patients
Mercy Medical Center CurrentSince Nov 1, 2023 Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

1340 Blairs Ferry Rd
Unit A
Hiawatha, IA 52233
Phone (319) 398-6694

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": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1306627443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BLAIRS FERRY RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522331900",
            "telephone_number": "319-398-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BLAIRS FERRY RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522331900",
            "telephone_number": "319-398-6575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Blairs Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Hiawatha",
            "state": "IA",
            "postal_code": "522331900",
            "country_code": "US",
            "telephone_number": "319-398-6575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "BARBARA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G176305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiawatha, IA

Sources for this page

Verify at the official NPI Registry.