Individual provider Active NPI

Roberta Price, MSW

  • Clinical Social Worker
  • Fredericksburg, VA
National Provider Identifier
1104920131
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904002263 Issued in VA
Practice address
1400 Princess Anne St
Fredericksburg, VA 22401-3639
Phone
(540) 940-2755
Fax
(540) 656-2274
NPI assigned
Sep 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904002263 VA Primary

Addresses

Primary practice location

1400 Princess Anne St
Fredericksburg, VA 22401-3639

Mailing address

1400 Princess Anne St
Fredericksburg, VA 22401-3639
Phone (540) 940-2755

Other identifiers 3

IdentifierTypeStateIssuer
324147OtherVATRICARE PROVIDER #
432064OtherVAANTHEM BCBS PROVIDER #
8928894MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000890 VA Practitioner - Clinical Social Worker 1850568627 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904002263VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Specialty Services LLC Past Accepting new patients
Mental Health Resources PC Clinical PastSince Nov 29, 2012 Accepting new patients

Organizations & group practices 3

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1104920131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PRINCESS ANNE ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013639",
            "telephone_number": "540-940-2755",
            "fax_number": "540-656-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PRINCESS ANNE ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013639",
            "telephone_number": "540-940-2755",
            "fax_number": "540-656-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "ROBERTA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER #",
            "identifier": "324147",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PROVIDER #",
            "identifier": "432064",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8928894",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.