Individual provider Active NPI

Jennifer Roth, LCSW

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1346556149
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9986 Issued in FL
Practice address
101 American Center PL Ste 108
Tampa, FL 33619-4452
Phone
(303) 726-1453
NPI assigned
Aug 31, 2010
Last updated
Jan 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW9986 FL Primary

Addresses

Primary practice location

101 American Center PL Ste 108
Tampa, FL 33619-4452

Mailing address

11040 Little Blue Heron Dr
Riverview, FL 33579-2418
Phone (303) 726-7453

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120208000465 FL Practitioner - Clinical Social Worker 7618134305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
A and R Psychiatric and Mental Health Services, LLCGroup PAC ID 0547427239, 2 clinicians

Practice addresses (Care Compare)

550 N Reo St
Suite 300
Tampa, FL 33609-1037
Phone (303) 726-1453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A and R Psychiatric and Mental Health Services, LLC Clinical CurrentSince Oct 1, 2011 Accepting new patients

Locations

13911 Carrollwood Village Run
Tampa, FL 33618
Phone (352) 518-5232

550 N Reo St
Ste 300
Tampa, FL 33609
Phone (303) 726-1453

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

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1346556149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11040 LITTLE BLUE HERON DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335792418",
            "telephone_number": "303-726-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AMERICAN CENTER PL STE 108",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194452",
            "telephone_number": "303-726-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.