Individual provider Active NPI

Mary Catherine Becker-Roth, RN

  • Registered Nurse
  • Whitefish Bay, WI
National Provider Identifier
1730770868
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
70566 Issued in WI
Practice address
5075 N Woodburn St
Whitefish Bay, WI 53217-5759
Phone
(262) 955-3320
NPI assigned
Feb 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 70566 WI Primary

Addresses

Primary practice location

5075 N Woodburn St
Whitefish Bay, WI 53217-5759

Mailing address

5075 N Woodburn St
Whitefish Bay, WI 53217-5759
Phone (262) 955-3320

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
70566WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1730770868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5075 N WOODBURN ST",
            "city": "WHITEFISH BAY",
            "state": "WI",
            "postal_code": "532175759",
            "telephone_number": "262-955-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 N WOODBURN ST",
            "city": "WHITEFISH BAY",
            "state": "WI",
            "postal_code": "532175759",
            "telephone_number": "262-955-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER-ROTH",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "70566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitefish Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.