Individual provider Active NPI

Annette Roberts

  • Massage Therapist
  • Southport, NC
National Provider Identifier
1083592067
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
2019 Cringle Loop SE Apt 103
Southport, NC 28461-7989
Phone
(607) 743-2426
NPI assigned
Aug 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X Primary

Addresses

Primary practice location

2019 Cringle Loop SE Apt 103
Southport, NC 28461-7989

Mailing address

2019 Cringle Loop SE Apt 103
Southport, NC 28461-7989

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

NPI Registry JSON

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1083592067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 CRINGLE LOOP SE APT 103",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284617989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 CRINGLE LOOP SE APT 103",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284617989",
            "telephone_number": "607-743-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.