STACY ROTH (NPI# 1689077018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689077018 |
| Entity Type | Individual |
| Full Name | STACY ROTH |
| Credential | APN |
| Practice Address |
4600 3rd St Moline IL 61265-6106 |
| Practice Telephone | 3097792031 |
| Mailing Telephone | 3097792031 |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2014-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0810X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Child & Family |
G106548 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427189075 | Stacy Anne Roth | Dietitian, Registered | 9039 W Church St, Apt 1h, Des Plaines, IL 60016-7008 | 2007-03-07 |
| 1356307029 | Stacy Roth | Physical Therapist | 2360 E Pershing Blvd, Cheyenne, WY 82001-5356 | 2006-04-21 |
| Street Address |
4600 3RD ST |
| City | MOLINE |
| State | IL |
| Zip Code | 61265-6106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609870351 | Ernest Lee Galbreath | Psychiatry & Neurology | 4600 3rd St, Moline, IL 61265-6106 | 2005-06-10 |
| 1316545601 | Tamelia Abbasi | Nurse's Aide | 4600 3rd St, Moline, IL 61265-6106 | 2020-10-09 |
| 1346856556 | Alexa Stombaugh | Case Manager/Care Coordinator | 4600 3rd St, Moline, IL 61265-6106 | 2020-09-22 |
| 1639785454 | Tracy Lynn Petersen | Case Manager/Care Coordinator | 4600 3rd St, Moline, IL 61265-6106 | 2020-09-17 |
| 1609489806 | Parneet Sahota | Student in an Organized Health Care Education/Training Program | 4600 3rd St, Moline, IL 61265-6106 | 2020-08-26 |
| 1477162212 | Camille Katrina Butler | Technician | 4600 3rd St, Moline, IL 61265-6106 | 2020-07-28 |
| 1659901106 | Gloria Maria Guillen | Nurse Practitioner | 4600 3rd St, Moline, IL 61265-6106 | 2020-01-23 |
| 1699305136 | Kaila Jenaman | Nurse Practitioner | 4600 3rd St, Moline, IL 61265-6106 | 2020-01-23 |
| 1114567559 | Salena Hutchins | Nurse's Aide | 4600 3rd St, Moline, IL 61265-6106 | 2020-01-14 |
| 1619516218 | Jenifer Regennitter | Counselor | 4600 3rd St, Moline, IL 61265-6106 | 2019-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861035438 | Ora Orthopedics, PC | Orthopaedic Surgery | 510 Valley View Drive, Moline, IL 61265 | 2019-10-25 |
| 1598231698 | Secure Dental Vi | Dentist | 106 16th St, Unit #90, Moline, IL 61265 | 2018-10-17 |
| 1487152088 | Fjellheim P.c | Chiropractor | 1535 47th Avenue, Suite 5, Moline, IL 61265 | 2018-01-29 |
| 1326567199 | Elizabeth Ann Teichler | Respiratory Therapist, Registered | 4360 7th Street, Moline, IL 61265 | 2017-09-13 |
| 1497279913 | Caroline M Mather | Behavioral Analyst | 2430 6th Avenue, Moline, IL 61265 | 2017-07-26 |
| 1639625239 | Elizabeth Anderson | Nurse's Aide | 4319 26th Ave Apt 1, Moline, IL 61265 | 2016-09-01 |
| 1437604154 | Lindsey Bollaert | Nurse Practitioner | 1100 36th Ave, Moline, IL 61265 | 2016-08-23 |
| 1437541869 | Divvymed, LLC | Pharmacy | 4300 44th Ave, Moline, IL 61265 | 2015-02-23 |
| 1477955250 | Todd Stone | Nurse Practitioner | 1100 3th Avenue, Moline, IL 61265 | 2014-09-23 |
| 1588084479 | Familia Dental Moline LLC | Dentist | 1102 4th Ave, Moline, IL 61265 | 2014-04-18 |
| Find all providers in zip 61265 | ||||
| Taxonomy Code | 364SP0810X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Child & Family |
| Definition to come... |
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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.