Active NPI
Derek Von Roemer Sr., PH.D.
- Clinical Psychologist
- Franklin, PA
National Provider Identifier
1811178932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS005187L
- Practice address
- 1 Dale Drive
MH/Mr Base Service Unit
Franklin, PA 16323 - Phone
- (814) 671-8888
- Fax
- (814) 432-9128
- NPI assigned
- Nov 16, 2007
- Last updated
- Mar 29, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS005187L | PA | Primary |
Addresses
Primary practice location
1 Dale Drive
MH/Mr Base Service Unit
Franklin, PA 16323
Mailing address
PO Box 1183
Franklin, PA 16323-5183
Phone (814) 432-4355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01535160 | Medicaid | PA |
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS005187L | PA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Directions Psychiatry PC | Past | Accepting new patients | |
| New Directions Psychiatry, PC | Past | Accepting new patients | |
| Annen Community Mental Health Services, LLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364515200000",
"number": "1811178932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1183",
"city": "FRANKLIN",
"state": "PA",
"postal_code": "163235183",
"telephone_number": "814-432-4355",
"fax_number": "814-432-9128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 DALE DRIVE",
"address_2": "MH/MR BASE SERVICE UNIT",
"city": "FRANKLIN",
"state": "PA",
"postal_code": "16323",
"telephone_number": "814-671-8888",
"fax_number": "814-432-9128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROEMER",
"first_name": "DEREK",
"middle_name": "VON",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-16",
"last_updated": "2013-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS005187L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01535160",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Franklin, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.