AMANDA NICOLE ROTH
NPI 1669107892
Military Health Care Provider - Independent Duty Medical Technicians in Crestview, FL

Active since July 21, 2022
703 MAJESTIC DR, CRESTVIEW, FL 32536(210) 899-9568 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Amanda Nicole Roth NPPES

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

AMANDA NICOLE ROTH (NPI 1669107892) is an individual independent duty medical technicians provider in Crestview, Florida and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1669107892
Entity TypeIndividualFemale
Primary Taxonomy1710I1003X
Provider Legal NameAMANDA NICOLE ROTH
Location Address703 MAJESTIC DRCrestview, FL 32536-2254
Mailing Address703 Majestic DrCrestview, FL 32536-2254 · (210) 899-9568
Sole ProprietorNo
Enumeration DateJuly 21, 2022
NPPES CertifiedJuly 21, 2022
NPI 1669107892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code1710I1003X
Definition
An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
703 MAJESTIC DR, Crestview, FL 32536

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 Amanda Roth's NPI number?

The NPI number for Amanda Roth is 1669107892. It was assigned to this individual provider in the NPPES registry on July 21, 2022.

Where is Amanda Roth located?

Amanda Roth practices at 703 Majestic Dr, Crestview, FL 32536. The listed phone number is (210) 899-9568.

What is Amanda Roth's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Medical Technicians, with taxonomy code 1710I1003X.

When was this NPI record last updated?

The NPPES record for Amanda Roth was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.