Active NPI
Jacquie Roth
- Pharmacist
- Fort Thompson, SD
National Provider Identifier
1700895687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5138
- Practice address
- Highway 34 & 47
Fort Thompson, SD 57339 - Phone
- (605) 245-1503
- NPI assigned
- Aug 7, 2006
- 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 | 5138 | SD | Primary |
Addresses
Primary practice location
Highway 34 & 47
Fort Thompson, SD 57339
Mailing address
PO Box 200
Highway 34 & 47
Fort Thompson, SD 57339
Phone (605) 245-1503
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5138 | Other | SD | STATE LICENSE (PHARMACY) |
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 |
|---|---|---|---|
| 5138 | SD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700895687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 200",
"address_2": "HIGHWAY 34 & 47",
"city": "FORT THOMPSON",
"state": "SD",
"postal_code": "57339",
"telephone_number": "605-245-1503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HIGHWAY 34 & 47",
"city": "FORT THOMPSON",
"state": "SD",
"postal_code": "57339",
"telephone_number": "605-245-1503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "JACQUIE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SD",
"license": "5138",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE (PHARMACY)",
"identifier": "5138",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Thompson, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.