# ROTH FAMILY MEDICINE AND MENTAL HEALTH

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144168881
- **Authorized official:** KYLE ABRAHAM ROTH FNP (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (208) 423-8132

## Contact information

- **Practice address:** 444 HOSPITAL WAY STE 422, POCATELLO, ID 83201-2744
- **Practice address phone:** (208) 423-8132
- **Practice address fax:** (208) 203-6420
- **Mailing address:** 444 HOSPITAL WAY STE 422, POCATELLO, ID 83201-2744
- **Mailing address phone:** (208) 423-8132
- **Mailing address fax:** (208) 203-6420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/24/2026
- **Last updated:** 06/11/2026