Kathryn Jill Roth, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-1287A Issued in ID

Practice address

1800 Flandro Dr
Ste 110
Pocatello, ID 83202-4936

Phone

(208) 904-1544

Fax

(208) 904-1052

NPI assigned

Jul 9, 2013

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)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• East Idaho Mental Health LLC

  • Counselor
  • Rexburg, ID
  • NPI 1629825526
  NPD

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1467893289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 FLANDRO DR",
            "address_2": "STE 110",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832024936",
            "telephone_number": "208-242-3723",
            "fax_number": "208-904-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FLANDRO DR",
            "address_2": "STE 110",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832024936",
            "telephone_number": "208-904-1544",
            "fax_number": "208-904-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KATHRYN",
        "middle_name": "JILL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1287A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Center for Healing
• Cassidy Michelle Roske, LPC
• Theresa L. Ross, PHD
• Roth Family Medicine and Mental Health
• Roth Family Medicine and Mental Health
• Kyle A Roth, NP
• Elizabeth Lassen Rowden, MS, RDN, LD
• Nathan T. Rowe, NP-C
• RSM PA PLLC
• Tenille Rudeen, SLP

• Family Nurse Practitioner in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.