Jack T Roberts Jr., MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

MD09957 Issued in TN

Practice address

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015

Phone

(865) 980-4897

Fax

(865) 977-4793

NPI assigned

Jun 10, 2006

Last updated

May 12, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

77.77 of 100Reported as group

Quality

58.61

Promoting interoperability

92

Improvement activities

40

Cost

73.97

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Blount Memorial Physician Group, Inc

  • Family Medicine Physician
  • Alcoa, TN
  • NPI 1699710194

  Internal Medicine

  Medicare reassignment NPD
• Blount Hospitalists PC

  • Hospitalist Physician
  • Maryville, TN
  • NPI 1679876411
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1013958917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014703",
            "telephone_number": "865-273-1752",
            "fax_number": "865-273-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045015",
            "telephone_number": "865-980-4897",
            "fax_number": "865-977-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JACK",
        "middle_name": "T",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "09957",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "MD09957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3161933",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon R Robbins, DPT
• Roberson Family Dental PLLC
• Aaron D Roberts, D.O
• Bruce T Roberts, MD
• Deborah B Roberts, LCSW
• Kirstin Haley Roberts
• Melissa Roberts, FNP
• Whitney Roberts, MS, RD, CDE
• Velma Susie Robertson, CCC-A
• Yvonne Lynn Robertson, LCSW

• Hospitalist Physician in Maryville, TN
• Providers in Maryville, TN by specialty
• Hospitalist Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.