Gregory Lee Roberson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

003284 Issued in WV

Practice address

415 Benedum Dr
Bridgeport, WV 26330-1503

Phone

(304) 842-9887

Fax

(304) 842-9888

NPI assigned

Apr 23, 2019

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

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• WV Therapy Services LLC

  • Specialist
  • Bridgeport, WV
  • NPI 1063692333
  Medicare reassignment NPD

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1124682406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BENEDUM DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301503",
            "telephone_number": "304-842-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BENEDUM DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301503",
            "telephone_number": "304-842-9887",
            "fax_number": "304-842-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "GREGORY",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "003284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyndsay Parcell Riley, MOT, OTR/L
• Karla Kay Rinehart, WV-LSW, B.S.
• Rise Up Health and Wellness, LLC
• Rita Bobb-Rollins, DDS, LTD.
• Kaylee Ritter
• Misty Lynn Robine, MHC
• Brandi Robinson, MSW
• Kristina Robinson, M.A., LPC
• Zabrya Lee Robson, MA, LPC
• Kyle Steven Rogers, DPT

• Physical Therapist in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.