Active NPI
Rachel Roth, NP-C
- Nurse Practitioner
- Bridgeton, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 2016009384
- Practice address
- 12266 De Paul Dr Ste 305
Bridgeton, MO 63044-2514 - Phone
- (314) 770-0991
- NPI assigned
- Jun 14, 2016
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2016009384 | MO | Primary |
Addresses
Primary practice location
12266 De Paul Dr Ste 305
Bridgeton, MO 63044-2514
Mailing address
PO Box 955534
Saint Louis, MO 63195-5534
Other practice location 1
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rroth151067@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12266 De Paul Dr
Suite 305
Bridgeton, MO 63044-2514
Phone (314) 770-0991
Hospital & facility affiliations
- SSM Health Depaul Hospital St Louis
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Medical Group Inc. | Current | Accepting new patients | |
| SSM Medical Group, Inc. | Current | Accepting new patients |
Locations
12266 De Paul Dr
Ste 305
Bridgeton, MO 63044
Phone (314) 770-0991
1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115
3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100
Interoperability endpoints
- rroth497286@direct-ehr-ssmhc.com
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Fenton, MO
- NPI 1700966207
-
- Durable Medical Equipment & Medical Supplies
- Warrenton, MO
- NPI 1467997155
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bridgeton, MO
- NPI 1598835308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700438400000",
"number": "1629428271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 955534",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631955534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12266 DE PAUL DR STE 305",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442514",
"telephone_number": "314-770-0991"
}
],
"practiceLocations": [
{
"address_1": "3015 N Ballas Rd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631312329",
"country_code": "US",
"telephone_number": "314-996-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROTH",
"first_name": "RACHEL",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-14",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MO",
"license": "2016009384",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rroth151067@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "rroth151067@direct-ehr-ssmhc.com",
"address_1": "12266 De Paul Dr Ste 305",
"city": "Bridgeton",
"state": "MO",
"country_code": "US",
"postal_code": "630442514",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "12266 De Paul Dr Ste 305",
"city": "Bridgeton",
"state": "MO",
"country_code": "US",
"postal_code": "630442514",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.