Active NPI
Marta B Roth, MD
- Family Medicine Physician
- Fairlawn, OH
National Provider Identifier
1528085503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35066638
- Practice address
- 3094 W Market St
Ste 136
Fairlawn, OH 44333-3617 - Phone
- (330) 864-0902
- Fax
- (330) 864-0920
- NPI assigned
- Jul 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35066638 | OH | Primary |
Addresses
Primary practice location
3094 W Market St
Ste 136
Fairlawn, OH 44333-3617
Mailing address
3094 W Market St
Ste 136
Fairlawn, OH 44333-3617
Phone (330) 864-0902
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0206502 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35066638 | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450051200000",
"number": "1528085503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3094 W MARKET ST",
"address_2": "STE 136",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443333617",
"telephone_number": "330-864-0902",
"fax_number": "330-864-0920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3094 W MARKET ST",
"address_2": "STE 136",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443333617",
"telephone_number": "330-864-0902",
"fax_number": "330-864-0920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "MARTA",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-16",
"last_updated": "2015-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35066638",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0206502",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairlawn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.