Individual provider Active NPI

Caroline M. Roth, APRN

  • Pediatric Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1740069723
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN11027430 Issued in FL
Practice address
5255 Office Park Blvd
Suite 110
Bradenton, FL 34203-3443
Phone
(941) 755-7000
Fax
(941) 755-7088
NPI assigned
Sep 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN11027430 FL Primary

Addresses

Primary practice location

5255 Office Park Blvd
Suite 110
Bradenton, FL 34203-3443

Mailing address

5255 Office Park Blvd
Suite 110
Bradenton, FL 34203-3443
Phone (941) 755-7000

Other identifiers 1

IdentifierTypeStateIssuer
120354500MedicaidFL

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

LicenseStateTypeSpecialty
APRN11027430FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Federico a. Frias MD PA PastSince Oct 6, 2024 Accepting new patients
Federico a. Frias MD PA PastSince Oct 6, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1740069723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 OFFICE PARK BLVD",
            "address_2": "SUITE 110",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033443",
            "telephone_number": "941-755-7000",
            "fax_number": "941-755-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 OFFICE PARK BLVD",
            "address_2": "SUITE 110",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033443",
            "telephone_number": "941-755-7000",
            "fax_number": "941-755-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "CAROLINE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-27",
        "last_updated": "2024-10-03",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11027430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120354500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.