Individual provider Active NPI

Greg James Wolber, PHD

  • Clinical Psychologist
  • Richmond, VA
National Provider Identifier
1841395308
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810000973 Issued in VA
Practice address
2805 McRae Rd
Suite 4a
Richmond, VA 23235
Phone
(804) 320-3456
Fax
(804) 320-3150
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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 0810000973 VA Primary

Addresses

Primary practice location

2805 McRae Rd
Suite 4a
Richmond, VA 23235

Mailing address

2805 McRae Rd
Suite 4a
Richmond, VA 23235
Phone (804) 320-3456

Other identifiers 3

IdentifierTypeStateIssuer
007708076MedicaidVA
4118466OtherVAAETNA
CAQH11240263OtherVACAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060123000846 VA Practitioner - Clinical Psychologist 3779507207 Practice locations: North Chesterfield, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2805 McRae Rd
North Chesterfield, VA 23235-3049
Phone (804) 320-3456

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810000973VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1841395308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 MCRAE RD",
            "address_2": "SUITE 4A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23235",
            "telephone_number": "804-320-3456",
            "fax_number": "804-320-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 MCRAE RD",
            "address_2": "SUITE 4A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23235",
            "telephone_number": "804-320-3456",
            "fax_number": "804-320-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLBER",
        "first_name": "GREG",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810000973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007708076",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4118466",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "CAQH11240263",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.