Active NPI
Anthony Roark
- Speech-Language Pathologist
- Beckley, WV
National Provider Identifier
1184899627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2501
- Practice address
- 200 Veterans Ave
Beckley, WV 25801-6444 - Phone
- (304) 255-2121
- NPI assigned
- Apr 25, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2501 | WV | Primary |
Addresses
Primary practice location
200 Veterans Ave
Beckley, WV 25801-6444
Mailing address
155 Huttons Vireo Dr
Martinsburg, WV 25405-3923
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7404027000 | Medicaid | WV |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2501 | WV | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740960000000",
"number": "1184899627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 HUTTONS VIREO DR",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254053923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 VETERANS AVE",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258016444",
"telephone_number": "304-255-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROARK",
"first_name": "ANTHONY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-25",
"last_updated": "2025-03-03",
"certification_date": "2025-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": "2501",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7404027000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.