Active NPI
Deanna Marie Roberts, ATC
- Sports Medicine (Orthopaedic Surgery) Physician
- Mount Pleasant, SC
National Provider Identifier
1063142578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 1230
- Practice address
- 1106 Chuck Dawley Blvd
Mount Pleasant, SC 29464-4183 - Phone
- (843) 876-0111
- NPI assigned
- Jun 16, 2022
- Last updated
- Jun 16, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 1230 | SC | Primary |
Addresses
Primary practice location
1106 Chuck Dawley Blvd
Mount Pleasant, SC 29464-4183
Mailing address
1471 Brightwood Dr
Mount Pleasant, SC 29466-7229
Phone (814) 322-8749
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000 | Other | NOT A BILLING PROVIDER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | robertde@musc.edu | Health Information Exchange (HIE) |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1230 | SC | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655337600000",
"number": "1063142578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1471 BRIGHTWOOD DR",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294667229",
"telephone_number": "814-322-8749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1106 CHUCK DAWLEY BLVD",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294644183",
"telephone_number": "843-876-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "DEANNA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-16",
"last_updated": "2022-06-16",
"certification_date": "2022-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "SC",
"license": "1230",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NOT A BILLING PROVIDER",
"identifier": "0000000",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "robertde@musc.edu",
"affiliation": "N",
"endpointDescription": "email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1106 Chuck Dawley Blvd",
"city": "Mount Pleasant",
"state": "SC",
"country_code": "US",
"postal_code": "294644183",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.