CARLEY MICHELE ROTH
NPI 1639034424
Nurse Practitioner in Fenton, MO

Active since December 23, 2025PECOS Enrolled
1055 BOWLES AVE STE 200, FENTON, MO 63026(636) 496-3900 Get Directions Write a Review

NPPES record last updated: April 21, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 21, 2026, Apr 10, 2026, Dec 23, 2025 (3 updates tracked since 2025).

About Carley Michele Roth NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLEY MICHELE ROTH (NPI 1639034424) is an individual nurse practitioner in Fenton, Missouri, licensed in Missouri (2026003319) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1639034424
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameCARLEY MICHELE ROTH
Location Address1055 BOWLES AVE STE 200Fenton, MO 63026-2308
Mailing AddressPo Box 955534Saint Louis, MO 63195-5534
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateDecember 23, 2025
Last NPPES UpdateApril 21, 20263 updates tracked since enumeration
NPPES CertifiedApril 21, 2026
NPI 1639034424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in MO · 2026003319
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 2026003319 (MO)
1055 BOWLES AVE STE 200, Fenton, MO 63026

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Carley Michele Roth is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID143703454
PECOS Enrollment IDI20260316000387
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63026 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1055 BOWLES AVE STE 200
FENTON, MO 63026
Psychiatry & Neurology (Neurology)
1055 BOWLES AVE STE 200
FENTON, MO 63026
Physician Assistant
1055 BOWLES AVE STE 200
FENTON, MO 63026
Nurse Practitioner
1055 BOWLES AVE STE 200
FENTON, MO 63026
Neurological Surgery
1055 BOWLES AVE STE 200
FENTON, MO 63026
Nurse Practitioner (Adult Health)
1055 BOWLES AVE STE 200
FENTON, MO 63026
Registered Nurse
1055 BOWLES AVE STE 200
FENTON, MO 63026
Nurse Practitioner (Adult Health)
1055 BOWLES AVE STE 200
FENTON, MO 63026

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carley Roth's NPI number?

The NPI number for Carley Roth is 1639034424. It was assigned to this individual provider in the NPPES registry on December 23, 2025.

Where is Carley Roth located?

Carley Roth practices at 1055 Bowles Ave Ste 200, Fenton, MO 63026. The listed phone number is (636) 496-3900.

What is Carley Roth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Carley Roth enrolled in Medicare?

Yes. Carley Roth is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carley Roth was last updated on April 21, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.