Active NPI
Sara Roshanna Rothberg, M.D.
- Internal Medicine Physician
- Charleston, WV
National Provider Identifier
1801982095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 14112
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001721506 | Medicaid | WV | |
| 550722686 | Other | WV | PRACTICE 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
| Organization | Specialty | Status | New 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.
-
- Emergency Medicine Physician
- South Charleston, WV
- NPI 1326087289
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.