Active NPI
Nancy Donley Roth
- Pharmacist
- Pueblo, CO
National Provider Identifier
1639654296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11284
- Practice address
- 4080 W Northern Ave
Pueblo, CO 81005-3597 - Phone
- (719) 561-0951
- Fax
- (719) 561-9646
- NPI assigned
- Sep 30, 2018
- Last updated
- Sep 30, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11284 | CO | Primary |
Addresses
Primary practice location
4080 W Northern Ave
Pueblo, CO 81005-3597
Mailing address
4080 W Northern Ave
Pueblo, CO 81005-3597
Phone (719) 561-0951
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11284 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538265600000",
"number": "1639654296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4080 W NORTHERN AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810053597",
"telephone_number": "719-561-0951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4080 W NORTHERN AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810053597",
"telephone_number": "719-561-0951",
"fax_number": "719-561-9646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "NANCY",
"middle_name": "DONLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-30",
"last_updated": "2018-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "11284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.