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Deactivated NPI 1881010056 Deactivated / Inactive NPI Female Practitioner

Brenda Sue Roth

Licensed Practical Nurse • Fulton, NY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Brenda Roth has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 12, 2014
NPI Deactivation Date January 03, 2020
Total Practice Duration ~6 Years of Practice (2014 – 2020)

Professional Overview & Biography Verified Profile Summary

Brenda Roth was a registered Licensed Practical Nurse practicing in Fulton, NY. Throughout an active medical career spanning 6 years, Brenda Roth provided care at the practice location at 277 S GRANBY RD until profile deactivation on 2020-01-03.

Practice Location & Contact Primary Location

Practice Address

277 S Granby Rd

Fulton, NY 130694342

Telephone 3152974161

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Fulton, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.0 Yrs
Regional Practice Density
57 Specialists

Practicing in Fulton, NY (23738 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License NY 234686-1

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 03, 2020

Record deactivated on January 03, 2020

NPI Profile Active March 12, 2014

NPI status registered as active in NPPES database

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Updated Practice Location March 12, 2014

Registered at 277 S GRANBY RD, FULTON, NY 130694342 (Tel: 3152974161)

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Updated Business Mailing Address March 12, 2014

Registered at 277 S GRANBY RD, FULTON, NY 130694342 (Tel: 3152974161)

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Provider Name / Credentials Updated March 12, 2014

Recorded as BRENDA ROTH

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 12, 2014

Licensed Practical Nurse (License #234686-1 in NY)

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Initial NPI Registration & Enumeration March 12, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1881010056
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 12, 2014
Last Update: March 12, 2014
Deactivation Date: January 03, 2020

Mailing Address

277 S Granby Rd

Fulton, NY 130694342

Phone: 3152974161

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.