Jaclyn Marie Roth, MS, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2011016811 Issued in MO

Practice address

2790 Clay Edwards Dr Ste 600
North Kansas City, MO 64116-3274

Phone

(816) 691-5048

Fax

(816) 346-7039

NPI assigned

Sep 14, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jackie Roth Other name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meritas Health Corporation 492 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/MtxVU3dbzZwHcvfCb2vTAE2_Nwhai9Oq/

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.

• Meritas Health Corporation

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1801875091

  MO

  Medicare reassignment Care Compare group NPD
• North Kansas City Hospital

  • General Acute Care Hospital
  • North Kansas City, MO
  • NPI 1558544981

  MO

  Medicare reassignment NPD
• Meritas Health Corporation

  • Rural Health Clinic/Center
  • Richmond, MO
  • NPI 1467811786
  Care Compare group
• Meritas Health Corporation

  • Neurology Physician
  • Kansas City, MO
  • NPI 1669323291
  NPD
• Meritas Health Corporation

  • Obesity Medicine (Preventive Medicine) Physician
  • North Kansas City, MO
  • NPI 1922690627
  NPD
• North Kansas City Hospital

  • Community/Retail Pharmacy
  • North Kansas City, MO
  • NPI 1003381948
  NPD
• Meritas Health Corporation

  • Neurology Physician
  • North Kansas City, MO
  • NPI 1023439833
  NPD (past)
• Meritas Health Corporation

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1184917288
  NPD (past)
• Meritas Health Corporation

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1619606159
  NPD (past)

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1891045076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 600",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163274",
            "telephone_number": "816-691-5048",
            "fax_number": "816-346-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 600",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163274",
            "telephone_number": "816-691-5048",
            "fax_number": "816-346-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "1048325",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2011016811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "ROTH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rachel L Rogers, FNP-C
• Jennifer J. Roggy, ANP-BC, AOCNP
• Ian M Rosbrugh, MD
• Howard M Rosen, M.D.
• Gregory Ross, PA-C
• Rowe'S Family Caregiving
• Evan Russell, DO
• Steven L Russell, MD
• RWW Outpatient Rehab Services, LLC
• Cody Robert Unruh Ryan, M.D.

• All providers in North Kansas City, MO
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.