Active NPI
Robyn W Roark, L.P.C
- Professional Counselor
- Boone, NC
National Provider Identifier
1053429357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4346
- Practice address
- 132 Poplar Grove Connector #B
Suite 201
Boone, NC 28607 - Phone
- (828) 773-9165
- NPI assigned
- Aug 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0000001924 | TN | |
| Professional Counselor | 101YP2500X | 4346 | NC | Primary |
Addresses
Primary practice location
132 Poplar Grove Connector #B
Suite 201
Boone, NC 28607
Mailing address
809 Ragan Rd
Trade, TN 37691-6114
Phone (423) 727-4795
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 10, 2024 through Apr 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000001924 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354665600000",
"number": "1053429357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 RAGAN RD",
"city": "TRADE",
"state": "TN",
"postal_code": "376916114",
"telephone_number": "423-727-4795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 POPLAR GROVE CONNECTOR #B",
"address_2": "SUITE 201",
"city": "BOONE",
"state": "NC",
"postal_code": "28607",
"telephone_number": "828-773-9165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROARK",
"first_name": "ROBYN",
"middle_name": "W",
"name_prefix": "Ms.",
"credential": "L.P.C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-27",
"last_updated": "2012-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "0000001924",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "4346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boone, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.