Individual provider Active NPI

Alan M Katz, PH.D.

  • Clinical Neuropsychologist
  • Roanoke, VA
National Provider Identifier
1952302127
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
0810001334 Issued in VA
Practice address
4330 Old Cave Spring Rd
Roanoke, VA 24018-3419
Phone
(540) 774-4211
Fax
(540) 989-8793
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 0810001334 VA Primary
Clinical Psychologist 103TC0700X 0810001334 VA

Addresses

Primary practice location

4330 Old Cave Spring Rd
Roanoke, VA 24018-3419

Mailing address

4330 Old Cave Spring Rd
Roanoke, VA 24018-3419
Phone (540) 774-4211

Other identifiers 3

IdentifierTypeStateIssuer
007709226MedicaidVA
264464OtherVAPSYCHOLOGIST
7707614MedicaidVA

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
I20101130000386 VA Practitioner - Clinical Psychologist 5092901231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4911 Brambleton Ave
Roanoke, VA 24018-4149
Phone (540) 774-4211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810001334VAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Counseling Center PC Clinical Neuropsychologist CurrentSince Oct 20, 2010 Accepting new patients

Locations

4911 Brambleton Ave
Roanoke, VA 24018
Phone (540) 774-4211

4330 Old Cave Spring Rd
Roanoke, VA 24018
Phone (540) 342-0411

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1952302127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 OLD CAVE SPRING RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183419",
            "telephone_number": "540-774-4211",
            "fax_number": "540-989-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 OLD CAVE SPRING RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183419",
            "telephone_number": "540-774-4211",
            "fax_number": "540-989-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "ALAN",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810001334",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001334",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007709226",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST",
            "identifier": "264464",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7707614",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.