Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carley Michele Roth

Individual provider Nurse Practitioner · NPI 1639034424

Carley Michele Roth is a Nurse Practitioner in Fenton, Missouri. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Missouri.

Years since qualifying
1
Licensed in
MO
In the registry since
2025
Specialties on file
2

Practice location Address checks out

1055 Bowles Ave Ste 200
Fenton, MO 63026-2308
Phone: (636) 496-3900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 2026003319 (MO)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 2026003319 (MO)

Record details

NPI number1639034424
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 23, 2025
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Fenton