MR. MICHAEL ANDREW ROTH (NPI# 1255860029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255860029 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL ANDREW ROTH |
| Credential | CAA |
| Practice Address |
201 Nw R D Mize Rd Blue Springs MO 64014-2513 |
| Mailing Address |
3645 Nw Blue Jacket Dr Lees Summit MO 64064-3017 |
| Practice Telephone | 8162285900 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2017-06-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326390220 | Michael Stewart Roth | Obstetrics & Gynecology | 2115 Ne 197th Ter, Miami, FL 33179-3127 | 2012-10-03 |
| 1457641110 | Michael Paul Roth | Behavioral Analyst | 3834 Birchwood Cir, Harrisburg, PA 17110-9385 | 2011-04-14 |
| 1093979262 | Michael Scott Roth | Chiropractor | 27 W Columbia St, Hempstead, NY 11550-2410 | 2008-07-16 |
| 1568654044 | Michael Roth | Ophthalmology | 1060 Chestnut St, Ann Arbor, MI 48104-2824 | 2007-08-17 |
| 1124225024 | Michael Donald Roth | Registered Nurse | 11133 Oliver Rd, Mc Kean, PA 16426-2236 | 2007-07-02 |
| 1740405687 | Michael D Roth | Dentist | 403 Washington Lane, Jenkintown, PA 19046 | 2007-04-16 |
| 1396893061 | Michael A Roth | Specialist | 42450 W 12 Mile Rd Ste 205, Novi, MI 48377-3030 | 2007-01-08 |
| 1912954827 | Michael Stuart Roth | Optometrist | 72057 Dinah Shore Dr, Suite D, Rancho Mirage, CA 92270-1791 | 2006-05-27 |
| 1811423957 | Michael Roth | Internal Medicine | Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA 23708 | 2017-05-10 |
| 1760927313 | Michael Roth | Physician Assistant | 8268 164th St, Suite 1b-02, Jamaica, NY 11432-1121 | 2017-01-05 |
| Street Address |
201 NW R D MIZE RD |
| City | BLUE SPRINGS |
| State | MO |
| Zip Code | 64014-2513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831197680 | Olga Alex Chernyak | Nurse Anesthetist, Certified Registered | 201 Nw R D Mize Rd, St. Mary's Medical Center/anesthesia Services of Blue S, Blue Springs, MO 64014-2513 | 2005-07-13 |
| 1053933150 | Corey Pagnotta | Surgery | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 | 2020-05-12 |
| 1104446376 | Benjamin Joel Koerner | Student in an Organized Health Care Education/Training Program | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 | 2020-04-17 |
| 1336789973 | Elizabeth Jonelle Martin | Physical Therapist | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 | 2020-01-12 |
| 1780157172 | Spine Pain and Rehab Associates LLC | Physical Medicine & Rehabilitation | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 | 2019-01-08 |
| 1306315692 | Jackson Emergency Physicians LLC | Emergency Medicine | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 | 2018-11-16 |
| 1952896748 | Sally Emma Smith | Surgery | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 | 2018-06-25 |
| 1851812945 | Luke Clippard | Surgery | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 | 2017-06-29 |
| 1982125076 | Troy Tyler | Surgery | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 | 2017-06-29 |
| 1356879563 | Lpp of Missouri LLC | Emergency Medicine | 201 Nw R D Mize Rd, Blue Springs, MO 64014 | 2017-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437756319 | Ltaj Properties LLC | Physical Therapist | 514 Nw State 7 Hwy, Suite A, Blue Springs, MO 64014 | 2020-10-05 |
| 1790397198 | Miranda Bramble | Pharmacist | 1701 Nw Highway 7, Blue Springs, MO 64014 | 2020-08-18 |
| 1659915098 | Cheif Smiles LLC | Dentist | 620 E. Us Highway 40, Blue Springs, MO 64014 | 2019-10-29 |
| 1629637764 | Beau Devereux Butzirus | Dentist | 1125 South Mo-7, Blue Springs, MO 64014 | 2019-06-12 |
| 1245725605 | Brian Geraghty | Orthopaedic Surgery | 201 Nw R D Mize Road, Blue Springs, MO 64014 | 2018-06-28 |
| 1588101224 | Andy Anderson | Prevention Professional | 2705 Nw 3rd Ter, Blue Springs, MO 64014 | 2017-01-19 |
| 1801250469 | Louis Spear | Dentist | 1215 A Nw 7 Highway, Blue Springs, MO 64014 | 2016-04-11 |
| 1083027411 | Alex Sharifian Dds Blue Springs Dentistry PC | Dentist | 1205 Ne Coronado Drive, Blue Springs, MO 64014 | 2014-06-03 |
| 1730512336 | Valerie Fombon | Pharmacist | 625 W 40 Hwy, Blue Springs, MO 64014 | 2013-08-19 |
| 1356692750 | Central Jackson County Fire Protection District | Ambulance | 805 Ne Jefferson St, Blue Springs, MO 64014 | 2012-09-25 |
| Find all providers in zip 64014 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144727637 | Ryan Hladky | Anesthesiologist Assistant | 4510 Frederick Blvd, St Joseph, MO 64506-3238 | 2018-04-10 |
| 1174956163 | Sara Leitner | Anesthesiologist Assistant | 2420 Menard St, Saint Louis, MO 63104-4330 | 2013-08-14 |
| 1538418793 | Brent R Fairbanks | Anesthesiologist Assistant | 1235 E Cherokee, Springfield, MO 65804-2203 | 2012-09-04 |
| 1184903460 | Ryan Mathew Clark | Anesthesiologist Assistant | 1500 N Oakland, Bolivar, MO 65613-3099 | 2011-08-04 |
| 1548265945 | Tyron A Townsend | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2005-06-14 |
| 1265042014 | Caitlin E Wagner | Anesthesiologist Assistant | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2020-08-06 |
| 1033736137 | Asher Herbet | Anesthesiologist Assistant | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-06 |
| 1083231070 | Lauren Gonzalez | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-25 |
| 1356966485 | Ashley Ann Eichelberger | Anesthesiologist Assistant | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2020-06-15 |
| 1124643622 | Adam Z Zino | Anesthesiologist Assistant | 615 S New Ballas Rd, Saint Louis, MO 63141-8221 | 2020-06-10 |
| Find all providers with the same taxonomy | ||||
| City | BLUE SPRINGS |
| Zip Code | 64014 |
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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.