Jared Kyle Rowberry, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4777 Issued in ID

Practice address

452 Cheney Dr W Ste 150
Twin Falls, ID 83301-4087

Phone

(855) 433-6825

NPI assigned

Jul 19, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1730532227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "855-433-6825",
            "fax_number": "503-952-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 CHENEY DR W STE 150",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014087",
            "telephone_number": "855-433-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8950 W Emerald St",
            "address_2": "Suite 108",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837044854",
            "country_code": "US",
            "telephone_number": "855-433-6825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROWBERRY",
        "first_name": "JARED",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toby Christopher Rood, RN, NP-C
• Jennifer Renee Rosa, OTR/L, CLT-LANA, CBI
• Julee Rose
• Tony Dean Rost, RPH, CDE
• Nancy Roth, LPC
• Jessica Rowe, LSW
• Kelsea Elizabeth Royer, SUDA
• Lesley Ruby, OT
• Jesse Michelle Ruggles, HIS
• Daniele J Ruhter, MS

• General Practice Dentistry in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.