Jennifer Isabel Roth, LIMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2203 Issued in NE

Practice address

822 N Lincoln Ave Ste a
York, NE 68467-2444

Phone

(402) 710-0564

Fax

(833) 382-0104

NPI assigned

Jun 30, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heartland Health Center IncGroup PAC ID 6103058607, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.roth.p1@direct.heartlandhealth.nextgenshare.com

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.

• Heartland Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Grand Island, NE
  • NPI 1275954299
  Medicare reassignment Care Compare group NPD
• Heartland Health Center Inc

  • Community/Retail Pharmacy
  • Grand Island, NE
  • NPI 1982403218
  NPD

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1689057325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 N LINCOLN AVE STE A",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684672444",
            "telephone_number": "402-710-0564",
            "fax_number": "833-382-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 N LINCOLN AVE STE A",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684672444",
            "telephone_number": "402-710-0564",
            "fax_number": "833-382-0104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2608 Old Fair Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Island",
            "state": "NE",
            "postal_code": "688035271",
            "country_code": "US",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "914 Road P",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "NE",
            "postal_code": "683613141",
            "country_code": "US",
            "telephone_number": "402-710-0564",
            "fax_number": "833-382-0104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JENNIFER",
        "middle_name": "ISABEL",
        "credential": "LIMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "10547",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025173100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Robertson, PMHNP BC, MSN, MBA
• Justin Rodriguez
• Lesly Rodriguez
• Kassandra G Roman, CNA/MA
• Paul Russell Rosenau, P.T.
• Rowe Lawn Service
• Christine Rowse
• Grace Ruffcorn
• Joe Ruffcorn
• Denise Saatmann

• Mental Health Counselor in York, NE
• Providers in York, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.

Verify at the official NPI Registry.