Active NPI
Robin Rosenthal, PH.D.
- Psychologist
- Atlanta, GA
National Provider Identifier
1023187341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1883
- Practice address
- 340 Boulevard NE
Suite 640
Atlanta, GA 30312-1273 - Phone
- (404) 653-1117
- Fax
- (404) 880-0133
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1883 | GA | Primary |
Addresses
Primary practice location
340 Boulevard NE
Suite 640
Atlanta, GA 30312-1273
Mailing address
340 Boulevard NE
Suite 640
Atlanta, GA 30312-1273
Phone (404) 653-1117
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000680369A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1883 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gary Santavicca, PH.D. and Associates | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Atlanta, GA
- NPI 1518171222
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023187341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 BOULEVARD NE",
"address_2": "SUITE 640",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303121273",
"telephone_number": "404-653-1117",
"fax_number": "404-880-0133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 BOULEVARD NE",
"address_2": "SUITE 640",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303121273",
"telephone_number": "404-653-1117",
"fax_number": "404-880-0133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENTHAL",
"first_name": "ROBIN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "1883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000680369A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.