Organization Active NPI

Jean L. Roberts, M.D., Family Medicine & Obstetric Care, LLC

  • Family Medicine Physician
  • Muncie, IN
National Provider Identifier
1154683472
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01067670A Issued in IN
Legal business name
JEAN L. ROBERTS, M.D., FAMILY MEDICINE & OBSTETRIC CARE, LLC
Practice address
804 W University Ave
Muncie, IN 47303-3863
Phone
(765) 760-2840
NPI assigned
Jun 12, 2012
Last updated
Jun 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Authorized official

Name
Dr. Jean Langley Roberts, M.D.
Title
Member/M.D.
Phone
(765) 760-2840

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01067670A IN Primary
Obstetrics & Gynecology Physician 207V00000X 01067670A IN

Addresses

Primary practice location

804 W University Ave
Muncie, IN 47303-3863

Mailing address

804 W University Ave
Muncie, IN 47303-3863

National Provider Directory

National Provider Directory

Locations

804 W University Ave
Muncie, IN 47303
Phone (765) 216-7345

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1154683472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 W UNIVERSITY AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 W UNIVERSITY AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033863",
            "telephone_number": "765-760-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN L. ROBERTS, M.D., FAMILY MEDICINE & OBSTETRIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "LANGLEY",
        "authorized_official_title_or_position": "MEMBER/M.D.",
        "authorized_official_telephone_number": "765-760-2840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01067670A",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01067670A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.