Individual provider Active NPI

Maggie Roth, APRN

  • Family Nurse Practitioner
  • Grand Island, NE
National Provider Identifier
1831740760
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
112878 Issued in NE
Practice address
908 N Howard Ave
Grand Island, NE 68803-3556
Phone
(308) 398-8900
NPI assigned
Sep 23, 2019
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 112878 NE Primary
Registered Nurse 163W00000X 82107 NE

Addresses

Primary practice location

908 N Howard Ave
Grand Island, NE 68803-3556

Mailing address

908 N Howard Ave Ste 105
Grand Island, NE 68803-3529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191029000353 NE Practitioner - Nurse Practitioner 4587996392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians

Practice addresses (Care Compare)

8207 Northwoods Dr
Suite 100
Lincoln, NE 68505-2093
Phone (402) 484-3440

908 N Howard Ave
Grand Island, NE 68803-3529

Hospital & facility affiliations

  • CHI Health St. Francis Hospital, Grand Island, NE, CCN 280023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
82107NEMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Specialty, LLC CurrentSince Nov 1, 2023 Accepting new patients
Alegent Creighton Clinic CurrentSince Mar 16, 2020 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

1423 7th St
Aurora, NE 68818
Phone (402) 694-3171

2620 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-6856

908 N Howard Ave
Ste 105
Grand Island, NE 68803
Phone (308) 384-7200

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

5005 S 153rd St
Ste 100
Omaha, NE 68137
Phone (402) 614-1258

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1831740760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 N HOWARD AVE STE 105",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688033529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N HOWARD AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688033556",
            "telephone_number": "308-398-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MAGGIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "112878",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "82107",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.