Active NPI
Virginia Roth, MSW
- Clinical Social Worker
- Bend, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L8552
- Practice address
- 2084 NE Professional CT
Bend, OR 97701-6077 - Phone
- (541) 383-3005
- Fax
- (541) 383-1883
- NPI assigned
- Oct 31, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1500639 | OH | |
| Clinical Social Worker | 1041C0700X | L8552 | OR | Primary |
Addresses
Primary practice location
2084 NE Professional CT
Bend, OR 97701-6077
Mailing address
600 SW Columbia St Ste 6250
Bend, OR 97702-1099
Phone (541) 383-3005
Other practice location 1
11059 E Bethany Dr
Aurora, CO 80014-2622
Phone (303) 617-2300
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.1500639 | OH | MD | Social Worker |
| L8552 | OR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mosaic Community Health | Current | Accepting new patients |
Locations
11059 E Bethany Dr
Ste 200
Denver, CO 80014
Phone (303) 617-2331
11059 E Bethany Dr
Denver, CO 80014
Phone (303) 617-2342
600 SW Columbia St
Ste 6250
Bend, OR 97702
2084 NE Professional Ct
Bend, OR 97701
Phone (541) 322-5753
375 NW Beaver St
Ste 101
Prineville, OR 97754
Phone (541) 316-6026
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.
-
- Federally Qualified Health Center (FQHC)
- Prineville, OR
- NPI 1083633184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675036800000",
"number": "1790237352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 SW COLUMBIA ST STE 6250",
"city": "BEND",
"state": "OR",
"postal_code": "977021099",
"telephone_number": "541-383-3005",
"fax_number": "541-383-1883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2084 NE PROFESSIONAL CT",
"city": "BEND",
"state": "OR",
"postal_code": "977016077",
"telephone_number": "541-383-3005",
"fax_number": "541-383-1883"
}
],
"practiceLocations": [
{
"address_1": "11059 E Bethany Dr",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "CO",
"postal_code": "800142622",
"country_code": "US",
"telephone_number": "303-617-2300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROTH",
"first_name": "VIRGINIA",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-31",
"last_updated": "2023-01-30",
"certification_date": "2023-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1500639",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L8552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.