Mary Deborah Roth, R.D.L.D

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2001016361 Issued in MO

Practice address

3009 N Ballas Rd Ste 216B
Ste 216B
Saint Louis, MO 63131-2322

Phone

(314) 996-4351

Fax

(314) 996-4591

NPI assigned

Nov 5, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1467606392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 216B",
            "address_2": "STE 216B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-996-4351",
            "fax_number": "314-996-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 216B",
            "address_2": "STE 216B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-996-4351",
            "fax_number": "314-996-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MARY",
        "middle_name": "DEBORAH",
        "name_prefix": "Mrs.",
        "credential": "R.D.L.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2001016361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Joseph Roth, MD
• Diane Roth, RN
• Georgia L Roth, LCSW
• Joseph Barrington Roth, OD
• Lisa M Roth, RNC NNP
• Toni Clara Roth, MD
• Daniel H Rothermich, DMD
• Julia Christine Rothermich, MA, LPC
• Maria Catherine Rothhaar, PHD
• Steven Mark Rothman, MD

• Registered Dietitian in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.