NPIMap

Organization Active NPI

Roberts Medical Psychology, Inc.

  • Prescribing (Medical) Psychologist
  • Albuquerque, NM
National Provider Identifier
1447579487
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
0043 Issued in NM
Legal business name
ROBERTS MEDICAL PSYCHOLOGY, INC.
Practice address
2929 Coors Blvd NW
201H
Albuquerque, NM 87120-1173
Phone
(505) 312-7070
Fax
(310) 553-5288
NPI assigned
May 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Authorized official

Name
Allan Ray Roberts, PH.D.
Title
President
Phone
(505) 312-7070

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PSY13524 CA
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 1255 NM
Prescribing (Medical) PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TP0016X 0043 NM Primary

Addresses

Primary practice location

2929 Coors Blvd NW
201H
Albuquerque, NM 87120-1173

Mailing address

1534 Reeves St
Los Angeles, CA 90035-2929
Phone (310) 552-2382

Other identifiers 2

IdentifierTypeStateIssuer
PSY135240MedicaidCA
57053243MedicaidNM

National Provider Directory

National Provider Directory

Locations

2929 Coors Blvd NW
Ste 201H
Albuquerque, NM 87120
Phone (505) 312-7070

Practitioners & affiliated clinicians

Practitioners 1

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": "1275004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475107200000",
    "number": "1447579487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 REEVES ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352929",
            "telephone_number": "310-552-2382",
            "fax_number": "310-553-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 COORS BLVD NW",
            "address_2": "201H",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201173",
            "telephone_number": "505-312-7070",
            "fax_number": "310-553-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTS MEDICAL PSYCHOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-28",
        "last_updated": "2016-09-29",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-312-7070",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13524",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "1255",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NM",
            "license": "0043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY135240",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57053243",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; 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.