Active NPI
Lorraine Sharon Roth, M.D.
- Psychiatry Physician
- Alexandria, VA
National Provider Identifier
1841211745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036-079508
- Practice address
- 6178 Edsall Rd
Apt. #96
Alexandria, VA 22304-5881 - Phone
- (571) 970-2406
- NPI assigned
- Jul 23, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychiatry Physician | 2084F0202X | 24614 | NC | |
| Forensic Psychiatry Physician | 2084F0202X | 036-079508 | IL | |
| Psychiatry Physician | 2084P0800X | 036-079508 | IL | Primary |
| Psychiatry Physician | 2084P0800X | 24614 | NC |
Addresses
Primary practice location
6178 Edsall Rd
Apt. #96
Alexandria, VA 22304-5881
Mailing address
6178 Edsall Rd
Apt. #96
Alexandria, VA 22304-5809
Phone (571) 970-2406
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-079508 | IL | MD | Forensic Psychiatry Physician |
| 24614 | NC | MD | Forensic Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unified Therapeutics LLC | 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.
-
- Family Medicine Physician
- Chicago, IL
- NPI 1154590305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315440000000",
"number": "1841211745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6178 EDSALL RD",
"address_2": "APT. #96",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223045809",
"telephone_number": "571-970-2406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6178 EDSALL RD",
"address_2": "APT. #96",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223045881",
"telephone_number": "571-970-2406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "LORRAINE",
"middle_name": "SHARON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-23",
"last_updated": "2011-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "NC",
"license": "24614",
"primary": false
},
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "IL",
"license": "036-079508",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036-079508",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "24614",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.