Individual provider Active NPI

Kayla Elizabeth Roth, PT, DPT.

  • Physical Therapist
  • Gainesville, VA
National Provider Identifier
1447534938
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211847 Issued in VA
Practice address
6862 Piedmont Center PLZ
Gainesville, VA 20155-4034
Phone
(703) 754-4690
NPI assigned
Oct 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305211847 VA Primary

Addresses

Primary practice location

6862 Piedmont Center PLZ
Gainesville, VA 20155-4034

Mailing address

7516 Iron Bar LN
Gainesville, VA 20155-2999
Phone (571) 261-9234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180525000630 VA Practitioner - Physical Therapist in Private Practice 7911123583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7516 Iron Bar LN
Gainesville, VA 20155-2999
Phone (571) 450-5879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305211847VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gainesville Physical Therapy Incorporated Physical Therapist CurrentSince Mar 6, 2019 Accepting new patients
Prime Physical Therapy LLC Physical Therapist CurrentSince Sep 27, 2023 Accepting new patients
Occupational Health Services 1 Past Accepting new patients

Locations

7516 Iron Bar Ln
Gainesville, VA 20155
Phone (571) 450-5879

6862 Piedmont Center Plz
Gainesville, VA 20155
Phone (703) 754-4690

7500 Iron Bar Ln
Ste 7516
Gainesville, VA 20155

Organizations & group practices 3

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": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1447534938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7516 IRON BAR LN",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201552999",
            "telephone_number": "571-261-9234",
            "fax_number": "757-720-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6862 PIEDMONT CENTER PLZ",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554034",
            "telephone_number": "703-754-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KAYLA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.