Dean Elmer Roach

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

3311 12TH St NW
Canton, OH 44708-3909

Phone

(330) 413-4107

NPI assigned

Oct 12, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• The Phoenix Recovery Support Services and Sober Living Environments LL

  • Peer Specialist
  • Canton, OH
  • NPI 1225769847
  NPD

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1609592609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 12TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447083909",
            "telephone_number": "330-413-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 12TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447083909",
            "telephone_number": "330-413-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "DEAN",
        "middle_name": "ELMER",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory F Rivera, RPH
• Yazira E Rivera
• Amy Leah Rivers
• Rize Up Counseling, LLC
• Nicole Rizzardi
• Karin Lynne Roach, LISW-S
• Brittany Nicole Roberson, LPN
• Robert Hamilton MD Inc
• Robert J Ripich & Bret Pavlica DDS LLC
• Roberto Novoa, M.D., LLC

• Peer Specialist in Canton, OH
• Providers in Canton, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.