Individual provider Active NPI

Ann M Roberts, MD

  • Pediatrics Physician
  • Spokane Valley, WA
National Provider Identifier
1154489722
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00043821 Issued in WA
Practice address
1414 N Vercler
Building 1
Spokane Valley, WA 99216-1092
Phone
(509) 928-6383
Fax
(509) 926-9420
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00043821 WA Primary

Addresses

Primary practice location

1414 N Vercler
Building 1
Spokane Valley, WA 99216-1092

Mailing address

1414 N Vercler Rd
Building 1
Spokane Valley, WA 99216-1092
Phone (509) 928-6383

Other identifiers 1

IdentifierTypeStateIssuer
1003787MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140205000129 WA Practitioner - Pediatric Medicine 7911136379 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Jan 1, 2014 Accepting new patients
Providence Health & Services Washington CurrentSince Jan 1, 2014 Accepting new patients
Trustees of the University of Pennsylvania Pediatrics Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

101 W 8th Ave
Ste 100
Spokane, WA 99204
Phone (509) 474-2880

101 W 8th Ave
Fl 3
Spokane, WA 99204
Phone (509) 474-2277

1414 N Vercler Rd
Ste 1
Spokane Valley, WA 99216
Phone (509) 924-4600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1154489722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 N VERCLER RD",
            "address_2": "BUILDING 1",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161092",
            "telephone_number": "509-928-6383",
            "fax_number": "509-926-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 N VERCLER",
            "address_2": "BUILDING 1",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161092",
            "telephone_number": "509-928-6383",
            "fax_number": "509-926-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ANN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00043821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003787",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.