Evelyn Roth

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

NP95008456 Issued in CA

Practice address

15785 Laguna Canyon Rd Ste 125
Irvine, CA 92618-3140

Phone

(866) 542-2865

Fax

(224) 538-3267

NPI assigned

May 21, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10665844
• Direct secure messaging: evelynroth@cem.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.

• Continuem

  • Urgent Care Clinic/Center
  • Lakewood, CA
  • NPI 1336716489

  Single Specialty

  NPD
• Shoreline Treatment Center, LLC

  • Marriage & Family Therapist
  • Long Beach, CA
  • NPI 1558844043

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1548751969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15785 LAGUNA CANYON RD STE 125",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183140",
            "telephone_number": "866-542-2865",
            "fax_number": "224-538-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15785 LAGUNA CANYON RD STE 125",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183140",
            "telephone_number": "866-542-2865",
            "fax_number": "224-538-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "EVELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "814703",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "NP95008456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA BRN",
            "identifier": "NP95008456",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jami Lyn Ross, LCSW, LICSW, CCTP,
• Oliver Ross
• Dana Rossi
• Molly Good Rossknecht, D.O.
• Marietoni Yelo Rosure
• Ryan Burton Rothrock
• Maureen A Roudine, LMFT
• Roula Creighton MD, Inc
• Nancy A Rouse, CNM
• Julie Marie Rousseau, CNM, RN

• Family Medicine Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.