LISA M ROTH (NPI# 1558576561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558576561 |
Entity Type | Individual |
Full Name | LISA M ROTH |
Credential | RNC NNP |
Practice Address |
1465 S Grand Blvd Saint Louis MO 63104-1003 |
Mailing Address |
3815 Holly Hills Blvd Saint Louis MO 63116-3134 |
Practice Telephone | 3145775631 |
Mailing Telephone | 3147524327 |
Enumeration Date | 2007-05-12 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LN0005X |
Nurse Practitioner Specialization: Neonatal, Critical Care |
066591 | MO | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346612272 | Lisa Roth | Nurse's Aide | 22294 Coffelt Rd, Saint Mary, MO 63673-9225 | 2015-10-30 |
1730116807 | Lisa Caren Roth | Allergy & Immunology | 10 Union Ave, Suite11a&b, Lynbrook, NY 11563-3397 | 2006-06-26 |
1841773959 | Lisa Marie Roth | Case Manager/Care Coordinator | 10 N Main St, Bristol, CT 06010-8122 | 2018-09-13 |
1083133235 | Lisa Hughes Roth | Dietitian, Registered | 12550 New Brittany Blvd Ste 200, Fort Myers, FL 33907-3655 | 2017-09-19 |
1295254522 | Lisa Carolyn Roth | Counselor | 101 E Broadway Ave, Bismarck, ND 58501-3840 | 2017-09-19 |
1336501857 | Lisa Sharon Roth | Psychologist | 399 Laurel St, Suite 5, San Francisco, CA 94118-1951 | 2016-03-23 |
1679986715 | Lisa Anne Roth | Pediatrics | 3401 Civic Center Blvd Rm 55, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4319 | 2014-06-06 |
1780823245 | Lisa Bettina Roth | Social Worker | 40 Park Ln, Highland, NY 12528 | 2009-02-06 |
1376704742 | Lisa Roth | Pediatrics | 1275 York Ave, Department of Pediatrics, New York, NY 10065-6007 | 2008-06-19 |
1871762609 | Lisa Michelle Roth | Specialist/Technologist | 21419 W Dove Valley Rd, Wittmann, AZ 85361-8412 | 2008-02-26 |
Street Address |
1465 S GRAND BLVD |
City | SAINT LOUIS |
State | MO |
Zip Code | 63104-1003 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528676921 | Gunjanpreet Kaur | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-07-21 |
1972128510 | Millicent Rose Palacios | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-06-09 |
1083241863 | Nathaniel Joseph Conner | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
1467089177 | Stacy Kollanur Mathews | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
1568099299 | Susan Aye Mya Oo | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
1861029514 | Gregory Joseph Weissler II | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
1154958874 | Brendan Michael Mcenery | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
1316574049 | Satvika Mikkilineni | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
1972130607 | Katherine Letha Randolph | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
1346877081 | Samuel Ryan Richey | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
Find all providers in zip 63104 |
Taxonomy Code | 363LN0005X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Neonatal, Critical Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215450812 | Theresa Diane Allen | Nurse Practitioner | 1 Childrens Pl Ste 5s15, Saint Louis, MO 63110-1002 | 2017-07-25 |
1538348016 | Cortney Lynn Button | Nurse Practitioner | 2302 England Town Rd, Saint Louis, MO 63129 | 2007-10-31 |
1699386417 | Kristen Bagby | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-08-14 |
1720696115 | Abigail Patricia Klatch | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-07-21 |
1730707068 | Alyssa Lavalle | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-07-13 |
1245858067 | Jessica Pona | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-07-08 |
1346889573 | Paige C Reque | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-01-06 |
1538706585 | Rita Millicent Stanley | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2019-12-09 |
1669019964 | Keatyn Renee Mcvietty | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2019-12-05 |
1003463381 | Emily Goetter | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1081 | 2019-08-21 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63104 |
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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.