Individual provider Active NPI

Sara Roshanna Rothberg, M.D.

  • Internal Medicine Physician
  • Charleston, WV
National Provider Identifier
1801982095
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14112 Issued in WV
Practice address
2345 Chesterfield Ave
Suite 301
Charleston, WV 25304-1062
Phone
(304) 344-2900
Fax
(304) 344-9385
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14112 WV Primary

Addresses

Primary practice location

2345 Chesterfield Ave
Suite 301
Charleston, WV 25304-1062

Mailing address

2345 Chesterfield Ave
Suite 301
Charleston, WV 25304-1062
Phone (304) 344-2900

Other identifiers 2

IdentifierTypeStateIssuer
001721506MedicaidWV
550722686OtherWVPRACTICE TAX ID#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Kanawha County, PLLC Past Accepting new patients

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1801982095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 CHESTERFIELD AVE",
            "address_2": "SUITE 301",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041062",
            "telephone_number": "304-344-2900",
            "fax_number": "304-344-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 CHESTERFIELD AVE",
            "address_2": "SUITE 301",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041062",
            "telephone_number": "304-344-2900",
            "fax_number": "304-344-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBERG",
        "first_name": "SARA",
        "middle_name": "ROSHANNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "14112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001721506",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE TAX ID#",
            "identifier": "550722686",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.