Individual provider Active NPI

Robin Rosenthal, PH.D.

  • Psychologist
  • Atlanta, GA
National Provider Identifier
1023187341
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1883 Issued in GA
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

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000680369AMedicaidGA

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

LicenseStateTypeSpecialty
1883GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.