MELINDA MARIE ROTH (NPI# 1154757045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154757045 |
| Entity Type | Individual |
| Full Name | MELINDA MARIE ROTH |
| Practice Address |
108 W Market St Bloomington IL 61701-3918 |
| Mailing Address |
Po Box 266 Cornell IL 61319-0266 |
| Practice Telephone | 3098275351 |
| Practice Fax Number | 3098296808 |
| Mailing Telephone | 8153439382 |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2020-09-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 041337908 | IL | Nursing Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
209010719 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
277000959 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
108 W MARKET ST |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245233493 | Mclean County Center for Human Services, Inc | Counselor | 108 W Market St, Bloomington, IL 61701-3918 | 2005-05-23 |
| 1194367425 | Abigail M Nieslawski | Counselor | 108 W Market St, Bloomington, IL 61701-3918 | 2019-10-08 |
| 1356995872 | Vanessa N Middlebrooks | Licensed Practical Nurse | 108 W Market St, Bloomington, IL 61701-3918 | 2019-08-01 |
| 1821640160 | Karen M Swineford | Counselor | 108 W Market St, Bloomington, IL 61701-3918 | 2019-07-16 |
| 1144872490 | Alison Nicole Hamlet | Counselor | 108 W Market St, Bloomington, IL 61701-3918 | 2019-07-16 |
| 1578115804 | Melissa Dawn Sill | Counselor | 108 W Market St, Bloomington, IL 61701-3918 | 2019-07-16 |
| 1740849728 | Jenny Johnson | Counselor | 108 W Market St, Bloomington, IL 61701-3918 | 2019-06-12 |
| 1699334664 | Hayley Nicole Wissmiller | Counselor | 108 W Market St, Bloomington, IL 61701-3918 | 2019-06-12 |
| 1740846351 | Elizabeth Anne Fillmore | Counselor | 108 W Market St, Bloomington, IL 61701-3918 | 2019-05-20 |
| 1518523133 | Karyn W Flores | Registered Nurse | 108 W Market St, Bloomington, IL 61701-3918 | 2019-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134780851 | Eric Lyakhovetsky | Nurse Practitioner | 327 W Saidah Rd, Bloomington, IN 47404-8965 | 2019-06-24 |
| 1477822344 | Wenjing Cao | Nurse Practitioner | 108 W. Market, Bloomington, IL 61701 | 2011-12-22 |
| 1679684203 | Colleen S Odonnell | Nurse Practitioner | 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 | 2006-08-31 |
| 1558970517 | Randy Bargo | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2020-07-27 |
| 1750921870 | Lotus Integrated Care, LLC | Nurse Practitioner | 654 S Walker St, Bloomington, IN 47403-2159 | 2020-01-07 |
| 1033768569 | Amanda Lavender | Nurse Practitioner | 727 W 2nd St, Bloomington, IN 47403-2209 | 2019-09-07 |
| 1396215786 | Hui Shi Serena Loh | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2018-11-28 |
| 1922583285 | Bettina Ervin-rodgers | Nurse Practitioner | 108 W Market St, Bloomington, IL 61701-3918 | 2018-10-02 |
| 1710479753 | Kevin Nelson Moore | Nurse Practitioner | 550 S Adams St, Bloomington, IN 47403 | 2018-06-05 |
| 1205287513 | Stephanie B. Pemberton | Nurse Practitioner | 3600 N Prow Rd, Bloomington, IN 47404-1616 | 2016-06-28 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.