Active NPI
Julia Roth, PT, DPT, OCS
- Physical Therapist
- Jacksonville, FL
National Provider Identifier
1689177032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007573
- Practice address
- Naval Hospital Jacksonville 2080 Child Street
Jacksonville, FL 32214-0001 - Phone
- (203) 984-1465
- NPI assigned
- Mar 12, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 007573 | KY | Primary |
Addresses
Primary practice location
Naval Hospital Jacksonville 2080 Child Street
Jacksonville, FL 32214-0001
Mailing address
Naval Branch Health Clinic Mayport
2104 Massey Avenue, Building 2104
Jacksonville, FL 32228
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VAD0000 | Medicaid | CA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007573 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709251200000",
"number": "1689177032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NAVAL BRANCH HEALTH CLINIC MAYPORT",
"address_2": "2104 MASSEY AVENUE, BUILDING 2104",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL HOSPITAL JACKSONVILLE 2080 CHILD STREET",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322140001",
"telephone_number": "203-984-1465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "JULIA",
"credential": "PT, DPT, OCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-12",
"last_updated": "2024-03-01",
"certification_date": "2024-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "007573",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "VAD0000",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.