Active NPI
Richard Lee Roth, M.D.
- Psychiatry Physician
- MC Lean, VA
National Provider Identifier
1497758098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101028447
- Practice address
- 6845 Elm St
Ste 210
MC Lean, VA 22101-3822 - Phone
- (703) 821-2337
- NPI assigned
- May 27, 2005
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101028447 | VA | Primary |
Addresses
Primary practice location
6845 Elm St
Ste 210
MC Lean, VA 22101-3822
Mailing address
6845 Elm St
Ste 210
MC Lean, VA 22101-3822
Phone (703) 821-2337
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8555 | Other | VA | CAREFILRST BC BS |
| 059999 | Other | VA | ANTHEM BC BS |
| 215112 | Other | VA | MAMSI |
| 215112 | Other | VA | ALLIANCE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222819200000",
"number": "1497758098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6845 ELM ST",
"address_2": "STE 210",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221013822",
"telephone_number": "703-821-2337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6845 ELM ST",
"address_2": "STE 210",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221013822",
"telephone_number": "703-821-2337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "RICHARD",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2008-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101028447",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFILRST BC BS",
"identifier": "8555",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC BS",
"identifier": "059999",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "215112",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE",
"identifier": "215112",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.