Organization Active NPI

Robert Alan Petry PC

  • Clinical Psychologist
  • Richmond, VA
National Provider Identifier
1104151125
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810002340 Issued in VA
Legal business name
ROBERT ALAN PETRY PC
Practice address
6964 Forest Hill Ave
Richmond, VA 23225-1659
Phone
(804) 320-7738
Fax
(804) 320-8738
NPI assigned
Oct 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Authorized official

Name
Robert Alan Petry, PH.D.
Title
Owner
Phone
(804) 320-7738

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 0810002340 VA Primary

Addresses

Primary practice location

6964 Forest Hill Ave
Richmond, VA 23225-1659

Mailing address

6964 Forest Hill Ave
Richmond, VA 23225-1659
Phone (804) 320-7738

National Provider Directory

National Provider Directory

Locations

6962 Forest Hill Ave
Richmond, VA 23225
Phone (804) 320-7738

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1104151125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6964 FOREST HILL AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232251659",
            "telephone_number": "804-320-7738",
            "fax_number": "804-320-8738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6964 FOREST HILL AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232251659",
            "telephone_number": "804-320-7738",
            "fax_number": "804-320-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT ALAN PETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-08",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "PETRY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-320-7738",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002340",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 22, 2013; 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.