Richard Charles Roth, D.C.

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

14746 Issued in CA

Practice address

655 Camino de Los Mares Ste 121
San Clemente, CA 92673-2809

Phone

(949) 498-3262

Fax

(949) 498-4718

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Richardson Chiropractic Inc

  • Chiropractor
  • San Clemente, CA
  • NPI 1497992648
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1508916230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 CAMINO DE LOS MARES STE 121",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732809",
            "telephone_number": "949-498-3262",
            "fax_number": "949-498-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 CAMINO DE LOS MARES STE 121",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732809",
            "telephone_number": "949-498-3262",
            "fax_number": "949-498-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "RICHARD",
        "middle_name": "CHARLES",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CA",
            "license": "14746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "DC0147460",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "DC14746",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "loracobilling@cox.net",
            "affiliation": "N",
            "address_1": "655 Camino De Los Mares Ste 121",
            "city": "San Clemente",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926732809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ronald Trosper DDS Inc
• Isabel Rosales, COTA/L
• Marc Rosenberg, BCBA, MFTI
• Gary Lyn Rosenthal
• Emily Christine Ross
• Peter Morris Rothenberg, M.D.,M.A.
• Sharon Marie Roybal, LMFT
• Tania Elizabeth Ruiz-Salgado, MFT
• Russell Thompson Chiropractic Inc
• Kristin Rutledge

• Orthopedic Chiropractor in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Orthopedic Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.