Active NPI
Anntez Roberson, NP
- Psychiatric/Mental Health Nurse Practitioner
- Mansfield, TX
National Provider Identifier
1083316533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 1096595
- Practice address
- 2384 Highway 287 N Ste 218
Mansfield, TX 76063-9207 - Phone
- (817) 546-8000
- Fax
- (817) 672-5172
- NPI assigned
- Mar 20, 2023
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1096595 | TX | Primary |
Addresses
Primary practice location
2384 Highway 287 N Ste 218
Mansfield, TX 76063-9207
Mailing address
2384 Highway 287 N Ste 218
Mansfield, TX 76063-9207
Phone (817) 546-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1096595 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679270400000",
"number": "1083316533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2384 HIGHWAY 287 N STE 218",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760639207",
"telephone_number": "817-546-8000",
"fax_number": "817-672-5172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2384 HIGHWAY 287 N STE 218",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760639207",
"telephone_number": "817-546-8000",
"fax_number": "817-672-5172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERSON",
"first_name": "ANNTEZ",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-20",
"last_updated": "2023-03-20",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "1096595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.