Active NPI
Robert L. Roberts, CRNA
- Certified Registered Nurse Anesthetist
- Plano, TX
National Provider Identifier
1093775553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 515758
- Practice address
- 3901 W 15TH St
Plano, TX 75075 - Phone
- (972) 519-1115
- Fax
- (972) 519-1456
- NPI assigned
- Mar 27, 2006
- Last updated
- Jun 26, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 515758 | TX | Primary |
Addresses
Primary practice location
3901 W 15TH St
Plano, TX 75075
Mailing address
PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119917606 | Medicaid | TX | |
| 81006U | Other | TX | BCBS |
| P00238524 | Other | TX | RAILROAD |
| 119917605 | Medicaid | TX | |
| 119917602 | Medicaid | TX | |
| 119917604 | Medicaid | TX |
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)
- Enrolled
- Credentials
- Certified Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529971200000",
"number": "1093775553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 840853",
"city": "DALLAS",
"state": "TX",
"postal_code": "752840853",
"telephone_number": "972-233-1999",
"fax_number": "972-233-3666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 W 15TH ST",
"city": "PLANO",
"state": "TX",
"postal_code": "75075",
"telephone_number": "972-519-1115",
"fax_number": "972-519-1456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "ROBERT",
"middle_name": "L.",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-27",
"last_updated": "2018-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "515758",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119917606",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "81006U",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00238524",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119917605",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119917602",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119917604",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.