Cullen Johnson Roth, RSPS, MHPS, PSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

1271-0621 Issued in TX

Practice address

12301 Main St
Houston, TX 77035-6207

Phone

(713) 275-5115

NPI assigned

Oct 22, 2019

Last updated

Jan 28, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706400000000",
    "number": "1558904557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 524132",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770524132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 MAIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770356207",
            "telephone_number": "713-275-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "CULLEN",
        "middle_name": "JOHNSON",
        "credential": "RSPS, MHPS, PSS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-22",
        "last_updated": "2024-01-28",
        "certification_date": "2024-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "TX",
            "license": "1271-0621",
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "TX",
            "license": "50028-0820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Fang Rote, MD
• Jewel Rotella, CRNP
• Joshua S Rotenberg, MD
• Michael Rotenberg, M.D.
• Roth Drug Company (Roth Drug Co)
• David R. Roth, MD
• Elise Roth
• Forrest Sussman Roth, M.D.
• Jack A. Roth, M.D.
• Jesse Levi Roth, D.C.

• Peer Specialist in Houston, TX
• Providers in Houston, TX by specialty
• Peer Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.