Roger Alan Koller

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

1782 Issued in VA

Practice address

513 Portwest CT
Richmond, VA 23238-5529

Phone

(804) 614-5944

NPI assigned

Mar 14, 2018

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720581986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PORTWEST CT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232385529",
            "telephone_number": "804-614-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 PORTWEST CT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232385529",
            "telephone_number": "804-614-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "ROGER",
        "middle_name": "ALAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "VA",
            "license": "1782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Stephen Kolar, DNP, CRNA
• Andrew Wayne Kolb, D.O.
• Megan Elizabeth Kolbe
• Bharadhwaj Kolipakkam, MD
• Miriam Koller Pizzani, MD
• Prashanta Bharadwaja Kolluru, M.D.
• Haley Kolos
• Ellen Koltz, LCSW
• Kathleen Ryer Komornik, OD
• Daniel J Komorowski, M.D.

• Peer Specialist in Richmond, VA
• Providers in Richmond, VA by specialty
• Peer Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.