Active NPI
Scott Jonathan Roberts, MPT
- Orthopedic Physical Therapist
- Richmond, VA
National Provider Identifier
1073547857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 2305203258
- Practice address
- 3514 Mayland CT
Richmond, VA 23233-1421 - Phone
- (804) 747-0003
- Fax
- (804) 747-0043
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 0019004823 | VA | |
| Specialist | 174400000X | 2305203258 | VA | |
| Orthopedic Physical Therapist | 2251X0800X | 2305203258 | VA | Primary |
Addresses
Primary practice location
3514 Mayland CT
Richmond, VA 23233-1421
Mailing address
3514 Mayland CT
Richmond, VA 23233-1421
Phone (804) 747-0003
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 283517 | Other | VA | SOUTHERN HEALTH SERVICES |
| 192519 | Other | VA | ANTHEM BCBS |
| 201597792 | Other | VA | TRICARE-NORTH |
| 2218247 | Other | VA | FIRST HEALTH |
| 201597792 | Other | VA | BEECH STREET CORPORATION |
| 201597792 | Other | VA | HEALTH NET FEDERAL SERV |
| 7230417 | Other | VA | AETNA |
| 0708920 | Other | VA | UNITED HEALTHCARE |
| 150239 | Other | VA | ALLIANCE PPO |
| 201597792 | Other | VA | GREAT-WEST HEALTHCARE |
| 2132404 | Other | VA | M.D.IPA HEALTH PLAN |
| 3695288 | Other | VA | AETNA |
| 9028006 | Other | VA | PHCS |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305203258 | VA | MD | Orthopedic Physical Therapist |
| 0019004823 | VA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602028800000",
"number": "1073547857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3514 MAYLAND CT",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232331421",
"telephone_number": "804-747-0003",
"fax_number": "804-747-0043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3514 MAYLAND CT",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232331421",
"telephone_number": "804-747-0003",
"fax_number": "804-747-0043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "SCOTT",
"middle_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2020-10-07",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "VA",
"license": "0019004823",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "VA",
"license": "2305203258",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "VA",
"license": "2305203258",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH SERVICES",
"identifier": "283517",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "192519",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE-NORTH",
"identifier": "201597792",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2218247",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEECH STREET CORPORATION",
"identifier": "201597792",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET FEDERAL SERV",
"identifier": "201597792",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7230417",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0708920",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE PPO",
"identifier": "150239",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT-WEST HEALTHCARE",
"identifier": "201597792",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "M.D.IPA HEALTH PLAN",
"identifier": "2132404",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3695288",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9028006",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.