Roth Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

WI2869 Issued in WI

Legal business name

ROTH CHIROPRACTIC PLLC

Practice address

315 SE Main St Apt 412
Minneapolis, MN 55414-4222

Phone

(612) 916-3506

NPI assigned

Dec 17, 2010

Organization subpart

No

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

Authorized official

Name

James Arthur Tacyshyn-Roth, D.C.NPI 1972515070

Title

Dr./Owner

Phone

(612) 916-3506

Specialties & licenses 1

Addresses

Other names 1

• Roth Chiropractic SC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Arthur Tacyshyn-Roth, DC

  • Chiropractor
  • West Allis, WI
  • NPI 1972515070

  MN

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520380800000",
    "number": "1710280490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 SE MAIN ST APT 412",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554144222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 SE MAIN ST APT 412",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554144222",
            "telephone_number": "612-916-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROTH CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-17",
        "last_updated": "2018-03-07",
        "status": "A",
        "authorized_official_last_name": "TACYSHYN-ROTH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "DR./OWNER",
        "authorized_official_telephone_number": "612-916-3506",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "WI2869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roth Chiropractic SC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Felor Rostami, MA, LGSW
• Halie Rostberg, PSY.D., LP
• Carise Marie Rotach-Beard, MA, LAMFT
• Antonio Rotel, RN
• Kristine Marie Rotel, LICSW
• Craig Stephen Roth, MD
• Elizabeth Roth, DNP
• Heidi Marie Roth
• Jacob Roth
• Kacie Roth, CNP

• Chiropractor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.