Active NPI
Laura Egerton Wert, PH.D.
- Clinical Psychologist
- Richmond, VA
National Provider Identifier
1972637551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810001671
- Practice address
- 5821 Staples Mill Rd
Richmond, VA 23228-5427 - Phone
- (804) 264-0966
- Fax
- (804) 264-1029
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810001671 | VA | Primary |
Addresses
Primary practice location
5821 Staples Mill Rd
Richmond, VA 23228-5427
Mailing address
5821 Staples Mill Rd
Richmond, VA 23228-5427
Phone (804) 264-0966
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007712332 | Medicaid | VA | |
| 453170 | Other | VA | BLUE CROSS AND BLUE SHIEL |
| 002529 | Other | VA | VALUE OPTIONS |
| 081163 | Other | VA | SOUTHERN HEALTH |
| 414195 | Other | VA | OPTIMUM/MDIPA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0810001671 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475539200000",
"number": "1972637551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5821 STAPLES MILL RD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232285427",
"telephone_number": "804-264-0966",
"fax_number": "804-264-1029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5821 STAPLES MILL RD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232285427",
"telephone_number": "804-264-0966",
"fax_number": "804-264-1029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WERT",
"first_name": "LAURA",
"middle_name": "EGERTON",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2016-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810001671",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007712332",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS AND BLUE SHIEL",
"identifier": "453170",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "002529",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH",
"identifier": "081163",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMUM/MDIPA",
"identifier": "414195",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.