Individual provider Active NPI

Julie H Roebuck, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlottesville, VA
National Provider Identifier
1487747572
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024166381 Issued in VA
Practice address
1215 Lee St
Charlottesville, VA 22908-1521
Phone
(434) 924-2231
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001153930 VA
Nurse Practitioner 363L00000X 0024166381 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024166381 VA Primary

Addresses

Primary practice location

1215 Lee St
Charlottesville, VA 22908-1521

Mailing address

PO Box 749112
Atlanta, GA 30374-9112
Phone (434) 295-1000

Other practice location 1

2101 Arlington Blvd
Charlottesville, VA 22903-1521
Phone (330) 758-4515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080215000190 VA Practitioner - Nurse Practitioner 0648353516 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001153930VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Jul 15, 2024 Accepting new patients
Jefferson Trail Treatment Center for Children Past Accepting new patients
Augusta Psychological Associates PastSince Apr 21, 2008 Accepting new patients

Locations

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

Interoperability endpoints

  • Direct secure messaging: jroebuck406347@direct.healthsystem.virginia.edu

Organizations & group practices 3

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1487747572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112",
            "telephone_number": "434-295-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229081521",
            "telephone_number": "434-924-2231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Arlington Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229031521",
            "country_code": "US",
            "telephone_number": "330-758-4515",
            "fax_number": "330-758-5121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROEBUCK",
        "first_name": "JULIE",
        "middle_name": "H",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001153930",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024166381",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024166381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.