Individual provider Active NPI

Kristina Roth, MD

  • Allergy & Immunology Physician
  • Columbus, OH
National Provider Identifier
1902303753
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
57.255890 Issued in OH
Practice address
915 Olentangy River Rd Ste 400
Columbus, OH 43212-3153
Phone
(614) 293-2090
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 57.255890 OH Primary
Pediatrics Physician 208000000X 57.255890 OH

Addresses

Primary practice location

915 Olentangy River Rd Ste 400
Columbus, OH 43212-3153

Mailing address

915 Olentangy River Rd Ste 400
Columbus, OH 43212-3153

Other practice location 1

555 S 18th St Fl 3
Columbus, OH 43205-2654
Phone (614) 722-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20210701002465 VA Practitioner - Pediatric Medicine 9931500618 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57.255890OHMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC Pediatrics CurrentSince Jul 1, 2021 Accepting new patients

Locations

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

3960 Virginia Beach Blvd
Virginia Beach, VA 23452
Phone (757) 668-4648

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1902303753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD STE 400",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD STE 400",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123153",
            "telephone_number": "614-293-2090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 S 18th St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052654",
            "country_code": "US",
            "telephone_number": "614-722-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KRISTINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "OH",
            "license": "57.255890",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "57.255890",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.