Charles N. Roberts, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00036933 Issued in WA

Practice address

5633 N. Lidergerwood
Spokane, WA 99208

Phone

(509) 482-0111

NPI assigned

Jan 29, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104962356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 N WASHINGTON ST",
            "address_2": "SUITE 209",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 N. LIDERGERWOOD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99208",
            "telephone_number": "509-482-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CHARLES",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00036933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8240764",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9611674",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "MD00036933",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDC PIN #",
            "identifier": "GAB10984",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Renck DDS PLLC (Lilac City Dental)
• Madison Marie Roberts-Haley, PA
• Aaron James Roberts, DNP, PMHNP-BC
• Amy Elizabeth Roberts, LMHC
• April Lee Roberts, PH.D.
• Daisha Rakisha-Lynn Roberts
• Danna Michelle Roberts, LMP
• Deanda Sylte Roberts, M.A.
• Deven T Roberts
• Jaeden Marie Roberts, LICSW

• Emergency Medicine Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.