Jessica Roane, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007506 Issued in VA

Practice address

3040 S Crater Rd Ste E
Petersburg, VA 23805-9247

Phone

(804) 731-6285

NPI assigned

Nov 6, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virginia Pac Services PCGroup PAC ID 4587930672, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Virginia Pac Services PC

  • Hospitalist Physician
  • Abingdon, VA
  • NPI 1073042800
  Medicare reassignment Care Compare group NPD
• CS Pacs 3 Southeast, LLC

  • Hospitalist Physician
  • Bluefield, WV
  • NPI 1154104958

  VA

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC

  Medicare reassignment NPD
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809

  VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1636156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636156800000",
    "number": "1992460737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 S CRATER RD STE E",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059247",
            "telephone_number": "804-731-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 S CRATER RD STE E",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059247",
            "telephone_number": "804-731-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROANE",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-06",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry J Rittmann, RPH
• Riverbend Integrative Therapy LLC
• Shaun Rivers, MSN RN
• Riverside Retirement Service, Inc
• Rizing Starz,LLC
• Marvin Van Roane
• Stacey O Roberts, LMT
• Tonette S Robertson, LCSW
• Amanda Robinson
• Rockwell-Pritchett Inc

• Clinical Psychologist in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.