David Roethe, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

1360 Issued in WI

Practice address

310 N Midvale Blvd Ste 202
Madison, WI 53705-3265

Phone

(608) 280-6486

Fax

(608) 238-1929

NPI assigned

Dec 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1548338239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N MIDVALE BLVD STE 202",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053265",
            "telephone_number": "608-280-6486",
            "fax_number": "608-238-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N MIDVALE BLVD STE 202",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053265",
            "telephone_number": "608-280-6486",
            "fax_number": "608-238-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROETHE",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WI",
            "license": "1360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39194800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Roehl
• Daniel Lawrence Roelke
• Mary Ann B Roelke, OTD, OTR
• Eric Christian Roenning
• Lisa Ann Roessler, OTR
• Judith Ann Roethe, MS CAPSW
• Lynn Ann Roethe, M.S., C.C.C.
• Carly Roethlisberger, OTR/L
• Zachary Roetz, PHARMD
• Rogers Memorial Hospital, Incorporated

• Counseling Psychologist in Madison, WI
• Providers in Madison, WI by specialty
• Counseling Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.