Andrea Lanao Roth-Roffy, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

UO4892 Issued in FL

Practice address

12391 S 4000 W
Riverton, UT 84096-7012

Phone

(801) 302-1700

NPI assigned

May 31, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Edward Via Col of Osteo Medicine-Carolinas Campus, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrealanao@rpf.allscriptsdirect.net

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.

• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368
  Medicare reassignment NPD
• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Valley City, UT
  • NPI 1184657041

  Pediatrics

  Medicare reassignment NPD (past)
• Granger Medical Clinic PC

  • Medical Specialty Clinic/Center
  • Sandy, UT
  • NPI 1871320028
  NPD
• Granger Medical Clinic, Inc.

  dba Granger Medical Clinic - Wasatch

  • Internal Medicine Physician
  • Salt Lake City, UT
  • NPI 1629163746
  NPD
• Granger Medical Specialists, LLC

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1497441539
  NPD
• Rainbow Pediatrics of Fayetteville

  • Pediatrics Physician
  • Fayetteville, NC
  • NPI 1356439566
  NPD
• Granger Medical Clinic PC

  dba Granger Medical West Jordan

  • Multi-Specialty Clinic/Center
  • West Jordan, UT
  • NPI 1104857549
  NPD (past)
• Rainbow Pediatrics

  • Neonatal Nurse Practitioner
  • Fayetteville, NC
  • NPI 1699148445
  NPD (past)

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1548618614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12391 S 4000 W",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967012",
            "telephone_number": "801-302-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1327 Robeson St",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283055531",
            "country_code": "US",
            "telephone_number": "104-865-4379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANAO ROTH-ROFFY",
        "first_name": "ANDREA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "UO4892",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "14260272-1204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrett Kordsiemon, PA-C
• Trevor Nichols Labrum, D.D.S.
• Jeanne Lajom, P.T.
• Bethany Christine Lambson, CNM
• Peter Demarcus Lambson, AMFT
• Jeffrey Allen Langworthy, S.S.W.
• Brendon Larimore
• Angelique Rosemary Larrabee
• Myra Rochelle Larsen, LCSW
• Sandra Larson

• Pediatrics Physician in Riverton, UT
• Providers in Riverton, UT by specialty
• Pediatrics Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.