Individual provider Active NPI

Richard Jonathan Roberts, PH.D.

  • Clinical Psychologist
  • Iowa City, IA
National Provider Identifier
1841393238
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
00504 Issued in IA
Practice address
601 Highway 6 W
Department of Veterans Affairs Medical Center
Iowa City, IA 52246-2208
Phone
(319) 338-0581
Fax
(319) 339-7068
NPI assigned
Sep 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 00504 IA Primary

Addresses

Primary practice location

601 Highway 6 W
Department of Veterans Affairs Medical Center
Iowa City, IA 52246-2208

Mailing address

601 Highway 6 W
Department of Veterans Affairs Medical Center
Iowa City, IA 52246-2208
Phone (319) 338-0581

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

LicenseStateTypeSpecialty
00504IAMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841393238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HIGHWAY 6 W",
            "address_2": "DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462208",
            "telephone_number": "319-338-0581",
            "fax_number": "319-339-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HIGHWAY 6 W",
            "address_2": "DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462208",
            "telephone_number": "319-338-0581",
            "fax_number": "319-339-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "RICHARD",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "00504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.