Organization Active NPI

Jonathan B Roth LLC

  • Pediatrics Physician
  • Edmond, OK
National Provider Identifier
1871891853
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
26618 Issued in OK
Legal business name
JONATHAN B ROTH LLC
Practice address
2000 E 15TH St
150A
Edmond, OK 73013-6697
Phone
(405) 348-6500
Fax
(405) 348-6501
NPI assigned
Mar 1, 2011
Last updated
Mar 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Authorized official

Name
Jonathan B Roth, MDNPI 1255517660
Title
MD
Phone
(405) 348-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 26618 OK Primary

Addresses

Primary practice location

2000 E 15TH St
150A
Edmond, OK 73013-6697

Mailing address

2000 E 15TH St Ste 150a
Edmond, OK 73013-6679
Phone (405) 348-6500

National Provider Directory

National Provider Directory

Locations

2000 E 15th St
Ste 150A
Edmond, OK 73013
Phone (405) 348-6500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298937600000",
    "number": "1871891853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E 15TH ST STE 150A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136679",
            "telephone_number": "405-348-6500",
            "fax_number": "405-348-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E 15TH ST",
            "address_2": "150A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136697",
            "telephone_number": "405-348-6500",
            "fax_number": "405-348-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN B ROTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-01",
        "last_updated": "2011-03-01",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "405-348-6500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "26618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.