NPIMap

Individual provider Active NPI

Gregory J Roberts, MD

  • Orthopaedic Surgery Physician
  • Cookeville, TN
National Provider Identifier
1043207574
Registry record updated May 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD036986 Issued in TN
Practice address
105 S Willow Ave
Cookeville, TN 38501-3138
Phone
(931) 526-9518
Fax
(931) 372-0087
NPI assigned
Sep 30, 2005
Last updated
May 14, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD036986 TN Primary

Addresses

Primary practice location

105 S Willow Ave
Cookeville, TN 38501-3138

Mailing address

105 S Willow Ave
Cookeville, TN 38501-3138
Phone (931) 526-9518

Other identifiers 1

IdentifierTypeStateIssuer
3880848MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040626000424 TN Practitioner - Orthopedic SurgeryPractitioner - Emergency Medicine 0941286389 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Tennessee, HSC, College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

105 S Willow Ave
Cookeville, TN 38501-4667
Phone (931) 526-9518

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement61
Knee replacement41
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD036986TNMDOrthopaedic Surgery Physician
36986TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic, PC Orthopaedic Surgery CurrentSince Aug 1, 2022 Accepting new patients
Amg - Livingston, LLC CurrentSince Dec 21, 2014 Accepting new patients
Campbell Clinic PC CurrentSince Aug 1, 2022 Accepting new patients
Amg-Livingston LLC Orthopaedic Surgery Current Accepting new patients
Amg Livingston LLC CurrentSince Dec 21, 2014 Accepting new patients
Upper Cumberland Orthopedic Surgery, PC Orthopaedic Surgery Past Accepting new patients
Campbell Clinic Past Accepting new patients

Locations

105 S Willow Ave
Cookeville, TN 38501
Phone (931) 372-7716

105 S Willow Ave
Ste 100
Cookeville, TN 38501
Phone (931) 267-4929

35 Taylor Ave
Crossville, TN 38555
Phone (865) 483-8478

310 Oak St
#B
Livingston, TN 38570
Phone (931) 403-5175

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

Interoperability endpoints

  • Direct secure messaging: gregory.roberts.1@1366.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1043207574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013138",
            "telephone_number": "931-526-9518",
            "fax_number": "931-372-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013138",
            "telephone_number": "931-526-9518",
            "fax_number": "931-372-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "GREGORY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD036986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3880848",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.