Courtney Roberts, LVN

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

326670 Issued in TX

Practice address

1510 S Vine Ave
Tyler, TX 75701-2826

Phone

(903) 526-4055

NPI assigned

Sep 18, 2021

Last updated

Sep 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Methadone Clinic of East Texas LLC

  dba Crossroads Treatment Centers Tyler

  • Methadone Clinic
  • Tyler, TX
  • NPI 1104144088
  NPD

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

{
    "created_epoch": "1631923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631923200000",
    "number": "1093485203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 TULLY TRL",
            "city": "WHITEHOUSE",
            "state": "TX",
            "postal_code": "757913127",
            "telephone_number": "903-921-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S VINE AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012826",
            "telephone_number": "903-526-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "COURTNEY",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-18",
        "last_updated": "2021-09-18",
        "certification_date": "2021-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "TX",
            "license": "326670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberson Chiropractic PLLC (Kayak Chiropractic)
• Matthew Dale Roberson, DC
• Robert Brock DDS PLLC
• Robert L. Boyne, M.D., P.a.
• Robert M. Sperry, PH.D., Inc. (Robert Sperry & Associates)
• Duana J Roberts, NP
• Eric Wayne Roberts, CRNA
• Erin Roberts
• Jamie M Roberts, CRNA
• Jill Ann Roberts, APN

• Addiction Medicine (Preventive Medicine) Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Addiction Medicine (Preventive Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2021; 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.