Stefanie Marie Roth, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

13-93878 Issued in KS

Practice address

7570 W 21St St N
Suite 1026 D
Wichita, KS 67205-1734

Phone

(316) 729-6555

NPI assigned

Nov 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stefanie Marie Bernklau Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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.

• Prairie View Inc

  • Community/Behavioral Health Agency
  • Newton, KS
  • NPI 1578252904
  NPD (past)
• Prairie View, Inc.

  • Psychiatry Physician
  • Newton, KS
  • NPI 1558426486
  NPD (past)

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1568835742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2946 N PARKDALE CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672056040",
            "telephone_number": "316-215-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7570 W 21ST ST N",
            "address_2": "SUITE 1026 D",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051734",
            "telephone_number": "316-729-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "STEFANIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "KS",
            "license": "13-93878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "BERNKLAU",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zenobia Ross
• Grace Rossow
• Steven Lee Rostetter, RN BSN
• Emily D Roth, MD
• Hannah L Roth, PA-C
• Wayne J Roth
• Macie Rotha
• Tamara Lynette Rothenberger, CRNA
• Ruth Elizabeth Rothlyn, APRN
• Kaytie Roughton

• Psychiatric/Mental Health Registered Nurse in Wichita, KS
• Providers in Wichita, KS by specialty
• Psychiatric/Mental Health Registered Nurse in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.

Verify at the official NPI Registry.