Active NPI
Roger Rattan, PHD
- Clinical Psychologist
- Madison, WI
National Provider Identifier
1417348046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 665-57
- Practice address
- 516 Troy Dr
Madison, WI 53704-1575 - Phone
- (608) 335-0694
- NPI assigned
- Feb 18, 2015
- Last updated
- Feb 18, 2015
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 665-57 | WI | Primary |
Addresses
Primary practice location
516 Troy Dr
Madison, WI 53704-1575
Mailing address
516 Troy Dr
Madison, WI 53704-1575
Phone (608) 335-0694
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 665-57 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424217600000",
"number": "1417348046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 TROY DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537041575",
"telephone_number": "608-335-0694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 TROY DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537041575",
"telephone_number": "608-335-0694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RATTAN",
"first_name": "ROGER",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-18",
"last_updated": "2015-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "665-57",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.