Individual provider Active NPI

Cristina Roberts

  • Primary Care Nurse Practitioner
  • Waller, TX
National Provider Identifier
1083060024
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
NP130900 Issued in TX
Practice address
975 Bowler Rd
Waller, TX 77484-9633
Phone
(832) 646-4182
NPI assigned
May 9, 2016
Last updated
May 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NP130900 TX Primary

Addresses

Primary practice location

975 Bowler Rd
Waller, TX 77484-9633

Mailing address

975 Bowler Rd
Waller, TX 77484-9633
Phone (832) 646-4182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170726000139 TX Order and Referring Only - Nurse Practitioner 2264702133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP130900TXMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1083060024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 BOWLER RD",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774849633",
            "telephone_number": "832-646-4182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 BOWLER RD",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774849633",
            "telephone_number": "832-646-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CRISTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "NP130900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waller, TX

Sources for this page

Verify at the official NPI Registry.