Individual provider Active NPI

Jane Ann Roth, RD

  • Renal Nutrition Registered Dietitian
  • Saginaw, MI
National Provider Identifier
1477582898
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
License
14777 Issued in IL
Practice address
4800 McLeod Dr E
Bay Area Regional Dialysis Ctr - CKD Services
Saginaw, MI 48604-2839
Phone
(989) 790-9440
Fax
(989) 790-1335
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X 14777 IL Primary

Addresses

Primary practice location

4800 McLeod Dr E
Bay Area Regional Dialysis Ctr - CKD Services
Saginaw, MI 48604-2839

Mailing address

545 E Dawn Dr
Freeland, MI 48623-9059
Phone (989) 695-5690

Other names 1

  • Jane Ann Mrozinski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14777ILMDRenal Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1477582898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 E DAWN DR",
            "city": "FREELAND",
            "state": "MI",
            "postal_code": "486239059",
            "telephone_number": "989-695-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 MCLEOD DR E",
            "address_2": "BAY AREA REGIONAL DIALYSIS CTR - CKD SERVICES",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042839",
            "telephone_number": "989-790-9440",
            "fax_number": "989-790-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JANE",
        "middle_name": "ANN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "IL",
            "license": "14777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "MROZINSKI",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.