Active NPI
Roy Keith Poth, M.D.
- Diagnostic Radiology Physician
- Austin, TX
National Provider Identifier
1952603334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- D 5157
- Practice address
- 15400 Fox Run Dr
Austin, TX 78737-8611 - Phone
- (512) 626-2643
- Fax
- (512) 301-3836
- NPI assigned
- Nov 17, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | D 5157 | TX | Primary |
Addresses
Primary practice location
15400 Fox Run Dr
Austin, TX 78737-8611
Mailing address
15400 Fox Run Dr
Austin, TX 78737-8611
Phone (512) 626-2643
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D 5157 | Other | TX | TEXAS STATE BOARD OF MEDICAL EXAMINERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D 5157 | TX | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289952000000",
"number": "1952603334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15400 FOX RUN DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787378611",
"telephone_number": "512-626-2643",
"fax_number": "512-301-3836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15400 FOX RUN DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787378611",
"telephone_number": "512-626-2643",
"fax_number": "512-301-3836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTH",
"first_name": "ROY",
"middle_name": "KEITH",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-17",
"last_updated": "2010-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "D 5157",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF MEDICAL EXAMINERS",
"identifier": "D 5157",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.