Active NPI
Jeaneen Ann Roberts, LMT
- Specialist
- Eau Claire, WI
National Provider Identifier
1134400021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 3902-146
- Practice address
- 534 Water St
Eau Claire, WI 54703-5631 - Phone
- (715) 829-9794
- NPI assigned
- Sep 6, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 3902-146 | WI | Primary |
Addresses
Primary practice location
534 Water St
Eau Claire, WI 54703-5631
Mailing address
8631 141St St
Chippewa Falls, WI 54729-5291
Phone (715) 829-9794
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3902-146 | WI | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315267200000",
"number": "1134400021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8631 141ST ST",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "547295291",
"telephone_number": "715-829-9794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "534 WATER ST",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547035631",
"telephone_number": "715-829-9794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JEANEEN",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-06",
"last_updated": "2011-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WI",
"license": "3902-146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.