DR. STACEY ROTH (NPI# 1770849929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770849929 |
| Entity Type | Individual |
| Full Name | DR. STACEY ROTH |
| Credential | DC |
| Practice Address |
1906 30th Ave S Moorhead MN 56560-5210 |
| Practice Telephone | 2182332517 |
| Mailing Telephone | 2182332517 |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NP0017X |
Chiropractor Specialization: Pediatric Chiropractor |
3114 | MN | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326285164 | Stacey Roth | Speech-Language Pathologist | 270 W 70th St, New York, NY 10023-4302 | 2009-01-15 |
| 1659359800 | Stacey Ann Roth | Counselor | 5800 Ash Spgs, House Springs, MO 63051-3654 | 2006-01-06 |
| 1497885883 | Stacey Robin Roth | Social Worker | 940 Avenue 64, Pasadena, CA 91105-2711 | 2007-03-06 |
| Street Address |
1906 30TH AVE S |
| City | MOORHEAD |
| State | MN |
| Zip Code | 56560-5210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144326349 | Jason D Roth | Chiropractor | 1906 30th Ave S, Moorhead, MN 56560-5210 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386298859 | Anna Mckay Fox | Pharmacist | 4000 28th Avenue S, Moorhead, MN 56560 | 2019-08-01 |
| 1972019727 | Michael Wayne Hilliard | Specialist/Technologist | 649 17th St S, Moorhead, MN 56560 | 2017-12-15 |
| 1508217183 | Kristen Johnson | Nurse Practitioner | 801 Belsly Boulevard, Moorhead, MN 56560 | 2016-06-25 |
| 1861877052 | Midwest Mental Health Clinic | Nurse Practitioner | 819 30th Ave S Office 206 Suite B, Moorhead, MN 56560 | 2015-07-29 |
| 1083037709 | Drake Counseling Services, Inc. | Clinic/Center | 715 11th Street North, Suite 204, Moorhead, MN 56560 | 2014-01-31 |
| 1710310917 | Lamar Terrell Hill | Social Worker | 420 Center Ave Ste 102, Moorhead, MN 56560 | 2013-08-12 |
| 1982956140 | Lilac Homes Corporation | Assisted Living Facility | 2615 Parkview Dr, Moorhead, MN 56560 | 2012-10-11 |
| 1487918462 | Paige Joy Hanson | Massage Therapist | 805 14th St. So., Msum Wellness Center, Moorhead, MN 56560 | 2012-06-25 |
| 1972809408 | Cslm, LLC | Assisted Living Facility | 2401 South 11th Street, Moorhead, MN 56560 | 2011-02-01 |
| 1972814846 | Paul Michael Fluto | Pharmacist | 3000 Hwy 10 East, Mooehead, MN 56560 | 2010-06-25 |
| Find all providers in zip 56560 | ||||
| Taxonomy Code | 111NP0017X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Pediatric Chiropractor |
| The Pediatric Chiropractor is a chiropractor with specialized, advanced training and certification in the evaluation, care and management of health and wellness conditions of infancy, childhood and adolescence. This specialist provides primary, comprehensive, therapeutic and preventative chiropractic health care for newborns through adolescents. |
| Notes: Source: Council on Chiropractic Pediatrics, American Chiropractic Association, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619272630 | Natural Living Chiropractic LLC | Chiropractor | 4827 W 123rd St, Savage, MN 55378-1364 | 2011-01-22 |
| 1649506528 | Erin Marie Anderson | Chiropractor | 4110 Minnehaha Ave, Minneapolis, MN 55406-3340 | 2009-10-27 |
| 1447481601 | Sara Jane Curell | Chiropractor | 108 N Saint Paul Ave, Fulda, MN 56131-9401 | 2009-08-05 |
| 1578799870 | Child and Family Chiropractic Center, LLC | Chiropractor | 4444 W. 76th St., Suite 100, Edina, MN 55435 | 2009-06-02 |
| 1205488244 | Joyce Cundiff | Chiropractor | 8441 Wayzata Blvd Ste 370, Minneapolis, MN 55426-1386 | 2019-07-10 |
| 1679940712 | Flynn Brown Chiropractic, Sc | Chiropractor | 1405 78th St Ste 100, Victoria, MN 55386-9723 | 2015-08-24 |
| 1669866968 | Tara Carlson | Chiropractor | 700 Twelve Oaks Center Dr, Suite 734, Wayzata, MN 55391-4401 | 2015-03-24 |
| 1285076950 | Seasons Family Chiropractic | Chiropractor | 8425 Seasons Pkwy, Suite 104b, Woodbury, MN 55125-4392 | 2013-07-23 |
| 1124386172 | Mallori Beth Dombrock | Chiropractor | 21450 Highway 7, Excelsior, MN 55331-7205 | 2012-04-27 |
| 1952675431 | Morgan Kaye Waterstraat Woods | Chiropractor | 4926 42nd Ave N, Robbinsdale, MN 55422-1731 | 2012-03-01 |
| Find all providers with the same taxonomy | ||||
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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.