Individual provider Active NPI

Robert A. Older, M.D.

  • Diagnostic Radiology Physician
  • Richmond, VA
National Provider Identifier
1184680795
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101 020136 Issued in VA
Practice address
9105 Stony Point Pkwy
Richmond, VA 23235-1979
Phone
(804) 287-1030
Fax
(804) 288-3529
NPI assigned
Apr 22, 2006
Sex
Male
Sole proprietor
No

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
Diagnostic Radiology Physician 2085R0202X 0101 020136 VA Primary

Addresses

Primary practice location

9105 Stony Point Pkwy
Richmond, VA 23235-1979

Mailing address

9105 Stony Point Pkwy
Richmond, VA 23235-1979

Other identifiers 11

IdentifierTypeStateIssuer
64186OtherVASENTARA FAMILY CARE
8036132OtherVACIGNA
2137661OtherVAALLIANCE
299905OtherVASOUTHERN HEALTH
53223OtherVACARENET
CA4541OtherVARAILROAD MEDICARE GROUP #
C06623OtherVAMEDICARE GROUP #
P00175475OtherVARAILROAD MEDICARE
1053721OtherVAAETNA HMO
1603383OtherVAUNITED HEALTHCARE
5475270OtherVAAETNA PPO

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 Medicine

State licenses

LicenseStateTypeSpecialty
0101 020136VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group Past Accepting new patients
Virginia Urology Center-Hopewell Past Accepting new patients

Organizations & group practices 2

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": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184680795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9105 STONY POINT PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232351979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105 STONY POINT PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232351979",
            "telephone_number": "804-287-1030",
            "fax_number": "804-288-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDER",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101 020136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA FAMILY CARE",
            "identifier": "64186",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8036132",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "2137661",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "299905",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARENET",
            "identifier": "53223",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CA4541",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "C06623",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00175475",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1053721",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1603383",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5475270",
            "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 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.