Individual provider Active NPI

Colette Roth

  • Physical Therapist
  • Los Gatos, CA
National Provider Identifier
1679025282
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT301602 Issued in CA
Practice address
815 Pollard Rd
Los Gatos, CA 95032-1438
Phone
(408) 378-6131
NPI assigned
Oct 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10533 MN
Physical Therapist 225100000X PT6136 ME
Physical Therapist 225100000X PTL.0018171 CO
Physical Therapist 225100000X PT301602 CA Primary

Addresses

Primary practice location

815 Pollard Rd
Los Gatos, CA 95032-1438

Mailing address

815 Pollard Rd
Los Gatos, CA 95032-1438
Phone (408) 378-6131

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

LicenseStateTypeSpecialty
PT301602CAMDPhysical Therapist
PTL.0018171COMDPhysical Therapist
PT6136MEMDPhysical Therapist
10533MNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1477785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1679025282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 POLLARD RD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321438",
            "telephone_number": "408-378-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 POLLARD RD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321438",
            "telephone_number": "408-378-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "COLETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-30",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10533",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT6136",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0018171",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT301602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.