Samuel Rogers Jr., PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810001141 Issued in VA

Practice address

2840 Electric Rd Ste 200
Roanoke, VA 24018-3551

Phone

(540) 772-5153

Fax

(540) 772-5158

NPI assigned

Feb 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Clinical Psychologist

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychological Health Roanoke PCGroup PAC ID 4981606076, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Psychological Health Roanoke PC

  • Clinical Psychologist
  • Roanoke, VA
  • NPI 1417975806
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1467424895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 ELECTRIC RD",
            "address_2": "SUITE 100",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183547",
            "telephone_number": "540-772-5153",
            "fax_number": "540-772-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 ELECTRIC RD STE 200",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183551",
            "telephone_number": "540-772-5153",
            "fax_number": "540-772-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SAMUEL",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010279569",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Roanoke",
            "affiliation": "N",
            "address_1": "2840 Electric Rd Ste 200",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240183551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Rodriguez, RD
• Willem Albert Johan Roelofsen IV, D.C.
• Kiersten Roesemann, APRN, FNP-C
• Caitlyn Rogers
• Cara Marie Rogers, DO
• Lana Beth Rogoff, DO
• Nicki Rohani
• Robyn Rohrig, RD
• Susan J Rokisky, CRNA
• Roller & Johnson Dentistry. P.C

• Clinical Psychologist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.