Kristine Wilhelmina Roth, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

4301081874 Issued in MI

Practice address

2825 Livernois Rd
Troy, MI 48083-1214

Phone

(313) 205-6056

Fax

(248) 680-2099

NPI assigned

Feb 21, 2007

Last updated

Apr 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Medicare reassignment NPD
• Henry Ford Health System

  • Psychiatry Physician
  • Detroit, MI
  • NPI 1447334750
  NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Heath System

  • Vascular & Interventional Radiology Physician
  • Detroit, MI
  • NPI 1013119817
  NPD
• Henry Ford Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1851410005
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1326183633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831214",
            "telephone_number": "313-205-6056",
            "fax_number": "248-680-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831214",
            "telephone_number": "313-205-6056",
            "fax_number": "248-680-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KRISTINE",
        "middle_name": "WILHELMINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301081874",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301081874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kroth8562@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2825 Livernois Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480831214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamal R Ross, M.D.
• Jean Marie Ross, M.D.
• Kandyce Ross
• Morgan Marie Ross
• Herbert J Roth Jr., MD
• Chelsea Rothfuss
• Paul Joseph Roubal, PHD PT
• Thomas Rountree
• Sarah Rouse, OTR/L
• Marla R. Rowe Gorosh, M.D.

• Child & Adolescent Psychiatry Physician in Troy, MI
• Providers in Troy, MI by specialty
• Child & Adolescent Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.