Roth Medical Clinic, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

MD 00035230 Issued in WA

Legal business name

ROTH MEDICAL CLINIC, LLC

Practice address

220 E Rowan Ave Ste 200
Spokane, WA 99207-1203

Phone

(509) 483-4403

Fax

(509) 489-7556

NPI assigned

Apr 26, 2011

Organization subpart

No

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

Authorized official

Name

Dr. William Terrence Roth, MDNPI 1124199989

Title

Owner

Phone

(509) 483-4403

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William T. Roth, MD

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1124199989
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1861783847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E ROWAN AVE STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071203",
            "telephone_number": "509-483-4403",
            "fax_number": "509-489-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E ROWAN AVE STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071203",
            "telephone_number": "509-483-4403",
            "fax_number": "509-489-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROTH MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-26",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TERRENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-483-4403",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "MD 00035230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1111145",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Rosson
• Blair Rossow
• Kurt Rosssbach, LCSW
• Erin Rost
• Jamie Lee Rosteck, LMHC
• Ashley Nicole Roth, LMHC, MHP, NCC
• Daniel Robert Roth, D.M.D.
• Jason Eric Roth, MD
• Laurie Joanne Roth
• Matthew D Roth

• Clinic/Center in Spokane, WA
• Providers in Spokane, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.