Individual provider Active NPI

Nichole M Rohrer, PSY.D.

  • Clinical Psychologist
  • Alexandria, VA
National Provider Identifier
1922196658
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810003977 Issued in VA
Practice address
4850 Mark Center Dr
Alexandria, VA 22311-1882
Phone
(703) 746-3400
NPI assigned
Oct 10, 2006
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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 0810003977 VA Primary

Addresses

Primary practice location

4850 Mark Center Dr
Alexandria, VA 22311-1882

Mailing address

4850 Mark Center Dr
Alexandria, VA 22311-1882
Phone (703) 746-3400

Other identifiers 1

IdentifierTypeStateIssuer
004945026MedicaidVA

Other names 1

  • Dr. Nichole M. Rohrer-Bassingthwaite Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20090213000348 DC Practitioner - Clinical Psychologist 1456416023 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810003977VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
City of Alexandria CurrentSince Jun 22, 2024 Accepting new patients
City of Alexandria CurrentSince Jun 22, 2024 Accepting new patients

Locations

4850 Mark Center Dr
Alexandria, VA 22311
Phone (703) 746-3400

4850 Mark Center Dr
Fl 9
Alexandria, VA 22311
Phone (703) 746-3400

720 N Saint Asaph St
Alexandria, VA 22314
Phone (703) 746-3400

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1922196658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 MARK CENTER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111882",
            "telephone_number": "703-746-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 MARK CENTER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111882",
            "telephone_number": "703-746-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHRER",
        "first_name": "NICHOLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945026",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "ROHRER-BASSINGTHWAITE",
            "middle_name": "M.",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.