Individual provider Active NPI

Cheryl Valerie Rozanov, MD

  • Psychiatry Physician
  • Lexington, NC
National Provider Identifier
1598709206
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2006-01890 Issued in NC
Practice address
1104A S Main St
Daymark Recovery Services Inc
Lexington, NC 27292-3134
Phone
(336) 242-2450
Fax
(336) 249-9920
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X M0992 TX
Child & Adolescent Psychiatry Physician 2084P0804X 2006-01890 NC
Psychiatry Physician 2084P0800X 2006-01890 NC Primary

Addresses

Primary practice location

1104A S Main St
Daymark Recovery Services Inc
Lexington, NC 27292-3134

Mailing address

284 Executive Park Dr
Suite 100
Concord, NC 28025-1831
Phone (704) 939-1100

Other identifiers 4

IdentifierTypeStateIssuer
5906307MedicaidNC
146CVOtherNCBLUE CROSS BLUE SHIELD
172704201MedicaidTX
8S1680OtherTXBLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address integratedcare@direct.daymarkrecovery.nextgenshare.com Direct Daymark Recovery Services Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080226000909 NC Practitioner - Psychiatry 9638270218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daymark Recovery Services IncGroup PAC ID 0547233975, 132 clinicians

Practice addresses (Care Compare)

1104 A S Main St
Lexington, NC 27292-3134
Phone (336) 242-2450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006-01890NCMDPsychiatry Physician
M0992TXMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. Psychiatry CurrentSince May 9, 2020 Accepting new patients

Locations

1000 N 1st St
Ste 1
Albemarle, NC 28001
Phone (704) 983-2117

284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118

1104B S Main St
Lexington, NC 27292
Phone (336) 300-8826

1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836

1400 Willow Ln
North Wilkesboro, NC 28659
Phone (336) 667-5151

2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616

227 N Main St
Troy, NC 27371
Phone (910) 572-3681

Interoperability endpoints

  • Direct secure messaging: cheryl.rozanov.p1@direct.daymarkrecovery.nextgenshare.com

Organizations & group practices 1

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1598709206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR",
            "address_2": "SUITE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251831",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104A S MAIN ST",
            "address_2": "DAYMARK RECOVERY SERVICES INC",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272923134",
            "telephone_number": "336-242-2450",
            "fax_number": "336-249-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZANOV",
        "first_name": "CHERYL",
        "middle_name": "VALERIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "M0992",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "2006-01890",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2006-01890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906307",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "146CV",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172704201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8S1680",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "integratedcare@direct.daymarkrecovery.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Daymark Recovery Services Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "284 Executive Park Dr",
            "address_2": "Suite 100",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280251831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

Verify at the official NPI Registry.