Individual provider Active NPI

Jewell Christina Roth

  • Student in an Organized Health Care Education/Training Program
  • Temple, TX
National Provider Identifier
1801484001
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2401 S 31St St # Msag407Q
Temple, TX 76508-0001
Phone
(541) 259-0200
NPI assigned
Jan 4, 2021
Last updated
Apr 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2401 S 31St St # Msag407Q
Temple, TX 76508-0001

Mailing address

2401 S 31St St # Msag407Q
Temple, TX 76508-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230602002705 TX Order and Referring Only - Family PracticePractitioner - Family Practice 2860859097

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1600 Providence Dr
Waco, TX 76707-2291

2401 S 31 St
Temple, TX 76508-0001

PO Box
Suite 5478
Pawtucket, RI 02862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Western University of Health Sciences PastSince Jan 1, 2021 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1801484001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST # MSAG407Q",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST # MSAG407Q",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "541-259-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JEWELL",
        "middle_name": "CHRISTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.