DR. RANDY ROTH (NPI# 1013068212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013068212 |
Entity Type | Individual |
Full Name | DR. RANDY ROTH |
Credential | M.D. |
Practice Address |
2809 Denny Ave Pascagoula MS 39581-5301 |
Practice Telephone | 2288095510 |
Practice Fax Number | 2288095519 |
Mailing Telephone | 2288095510 |
Mailing Fax Number | 2288095519 |
Enumeration Date | 2007-01-15 |
Last Update Date | 2014-03-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207R00000X | Internal Medicine | MS14779 | MS | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
BLUE CROSS OF MS | 646000515E | 01 | |
MEDICARE RAILROAD | 60039090 | 01 | |
AL | 009917145 | 05 | |
MS | RR00116679 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487007118 | Randy Simon Roth | Dentist | 1100 Florida Ave, New Orleans, LA 70119-2715 | 2016-07-18 |
1104979616 | Randy A Roth | Nurse Anesthetist, Certified Registered | 274 E Chicago St, Coldwater, MI 49036-2041 | 2007-01-19 |
1093892622 | Randy Scott Roth | Psychologist | 325 E Eisenhower Pkwy, Ann Arbor, MI 48108-3364 | 2006-11-01 |
Street Address |
2809 DENNY AVE |
City | PASCAGOULA |
State | MS |
Zip Code | 39581-5301 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154316032 | Debby Ann Koffskey-beech | Social Worker | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2005-09-15 |
1356941397 | Lindsey Nicole Mcfaul | Registered Nurse | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2020-10-28 |
1457958910 | Courtney Tucker | Nurse Practitioner | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2020-10-07 |
1811502628 | Hillary Paige Weaver | Nurse Practitioner | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2020-09-09 |
1316559891 | Ashley Ann Gaffney | Registered Nurse | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2020-08-17 |
1851938898 | Singing River Health System | Pharmacy | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2019-12-10 |
1295379741 | Shelby Alexis Parker | Speech-Language Pathologist | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2019-10-28 |
1366083040 | Kyla Austin Richburg | Nurse Practitioner | 2809 Denny Ave, Pascagoula, MS 39581-5300 | 2019-10-03 |
1124586086 | Anganatte Nicole Williams | Nurse Practitioner | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2019-03-08 |
1205394442 | Kyrissa Malley | Dietitian, Registered | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2019-03-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760945448 | Jacquelyn B Ellison | Nurse Practitioner | 4105 Hospital Road, Ste 103, Pascagoula, MS 39581 | 2019-04-10 |
1104346816 | Jennifer Ngoc Bui | Dentist | 4001 Denny Ave Suite 1, Pascagoula, MS 39581 | 2017-06-23 |
1528486289 | Thomas Stallworth | Nurse Practitioner | 4105 Hospital St Ste 104, Pascagoula, MS 39581 | 2014-03-31 |
1487919957 | Candace Noel Pendowski | Nurse Practitioner | 4211 Hospital St Suite 208, Pascagoula, MS 39581 | 2012-07-10 |
1649548892 | Kim M. Tumminello | Nurse Practitioner | 4253 Denny Avenue, Pascagoula, MS 39581 | 2011-12-02 |
1649547860 | Abrian Norell Flowers | Physical Therapist | 3537 Denny Avenue, Suite 115, Pascagoula, MS 39581 | 2011-11-17 |
1164724118 | Coast To Coast Rehab LLC | Rehabilitation Practitioner | 3537 Denny Ave, Suite 115, Pascagoula, MS 39581 | 2010-11-24 |
1740500958 | Joshua Eric Tucker | Physical Medicine & Rehabilitation | 4105 Hospital St Ste 112b, Pascagoula, MS 39581 | 2010-06-10 |
1720164916 | Vernon W Doster | Family Medicine | 3616 Hospital Street, Suite D, Pascagoula, MS 39581 | 2006-10-31 |
1841387727 | David Bruce Allen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4300 Hospital Rd, Suite 105, Pascagoula, MS 39581 | 2006-10-10 |
Find all providers in zip 39581 |
Taxonomy Code | 207R00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710499744 | Robert B. Burns, Md | Internal Medicine | 4211 Hospital St Ste 206, Pascagoula, MS 39581-5311 | 2017-10-31 |
1790951796 | Samuel Joseph Simmons IIi, Inc. | Internal Medicine | 3601 Beach Blvd, #3, Pascagoula, MS 39567-7595 | 2008-04-30 |
1720179401 | Robert Benjamin Burns | Internal Medicine | 4603 Hospital St, Ste A, Pascagoula, MS 39581-5337 | 2006-09-27 |
1811425945 | Christina Marie Daniel | Internal Medicine | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2017-06-02 |
1598299786 | Chelsey Lynn Hill | Internal Medicine | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2017-04-14 |
1760914246 | Caleb Andrew Peyton | Internal Medicine | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2017-04-03 |
1457795684 | Joshua Coker | Internal Medicine | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2013-04-18 |
1053670166 | Ediz Tasan | Internal Medicine | 4300 Hospital St Ste 102, Pascagoula, MS 39581 | 2012-05-09 |
1598077059 | Gregory Ryan Culpepper | Internal Medicine | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2010-07-12 |
1548586399 | Renee Shiao | Internal Medicine | 4511 Hospital St, Pascagoula, MS 39581-5336 | 2010-04-19 |
Find all providers in PASCAGOULA |
City | PASCAGOULA |
Zip Code | 39581 |
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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.