Mason Roach

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202010448 Issued in VA

Practice address

39 Bank St
Chatham, VA 24531-1129

Phone

(434) 432-2761

Fax

(434) 432-2893

NPI assigned

Aug 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pittsylvania County Schools

  • Local Education Agency (LEA)
  • Chatham, VA
  • NPI 1548274848
  NPD (past)

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1497420319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7780 RENAN RD",
            "city": "HURT",
            "state": "VA",
            "postal_code": "245632077",
            "telephone_number": "434-841-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 BANK ST",
            "city": "CHATHAM",
            "state": "VA",
            "postal_code": "245311129",
            "telephone_number": "434-432-2761",
            "fax_number": "434-432-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "MASON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204000684",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202010448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pittsylvania County Schools
• Positive Behavior Supports Plus, Inc.
• Abigail Marie Puskas, PT, DPT
• William Howard Randolph, DDS
• Donald Andrew Reagan, DPT
• Vicky Lynn Robertson
• Christy W Robinson, PNP
• Jeneen L Robinson
• Kelly G Rowland, MS/CCC-SLP
• Suzanne Wood Sanford, LPC

• Speech-Language Pathologist in Chatham, VA
• Providers in Chatham, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.