Active NPI
Michaela Lynne Roberts, MD
- Family Medicine Physician
- Cornelius, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2025-01539
- Practice address
- 19485 Old Jetton Rd Ste 100
Cornelius, NC 28031-6583 - Phone
- (704) 384-1775
- Fax
- (704) 384-1776
- NPI assigned
- Jun 20, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2025-01539 | NC | Primary |
| Family Medicine Physician | 207Q00000X | 11022499A | IN |
Addresses
Primary practice location
19485 Old Jetton Rd Ste 100
Cornelius, NC 28031-6583
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other practice location 1
750 Broadway Ste 350
Fort Wayne, IN 46802-1412
Phone (260) 423-2675
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Novant Health Medical Group, LLC
Practice addresses (Care Compare)
19485 Old Jetton Rd
Suite 100
Cornelius, NC 28031-6583
Phone (704) 384-1775
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Family Medicine | Current | Accepting new patients |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients |
Locations
10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000
19485 Old Jetton Rd
Ste 100
Cornelius, NC 28031
Phone (704) 316-5170
16525 Holly Crest Ln
Ste 150
Huntersville, NC 28078
Phone (704) 384-1725
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- mroberts1714237@direct.novanthealth.org
- michaela.roberts.1@17223.direct.athenahealth.com
Organizations & group practices 5
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.
-
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1306950282
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1134841802
-
- Family Medicine Physician
- Cornelius, NC
- NPI 1356394308
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754956800000",
"number": "1154052397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19485 OLD JETTON RD STE 100",
"city": "CORNELIUS",
"state": "NC",
"postal_code": "280316583",
"telephone_number": "704-384-1775",
"fax_number": "704-384-1776"
}
],
"practiceLocations": [
{
"address_1": "750 Broadway Ste 350",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468021412",
"country_code": "US",
"telephone_number": "260-423-2675",
"fax_number": "260-423-6211",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTS",
"first_name": "MICHAELA",
"middle_name": "LYNNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-20",
"last_updated": "2025-08-12",
"certification_date": "2025-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2025-01539",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "11022499A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cornelius, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.