Roberto S Mauricio, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD0000007826 Issued in TN

Practice address

102 Old Jefferson St
Celina, TN 38551

Phone

(931) 243-3576

Fax

(931) 243-2751

NPI assigned

Oct 6, 2006

Last updated

Sep 20, 2026By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clay County Outpatient Clinic

  • Family Medicine Physician
  • Celina, TN
  • NPI 1992988638
  Authorized official Same address or phone
• Cumberland River Hospital Inc

  dba Cumberland River Physician Associates

  • Family Medicine Physician
  • Celina, TN
  • NPI 1558676445
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789862400000",
    "number": "1184711673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 OLD JEFFERSON ST",
            "city": "CELINA",
            "state": "TN",
            "postal_code": "38551",
            "telephone_number": "931-243-3576",
            "fax_number": "931-243-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 OLD JEFFERSON ST",
            "city": "CELINA",
            "state": "TN",
            "postal_code": "38551",
            "telephone_number": "931-243-3576",
            "fax_number": "931-243-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURICIO",
        "first_name": "ROBERTO",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2026-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000007826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3152445",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13790",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Joane Head
• Harry Horne, DO
• Integrity Healthcare of Celina, LLC (Celina Health and Rehabilitation Center)
• Gabriel Johnson, FNP-C
• Heather Kirk, LPN
• Amanda Naff, RN
• Whitney Farren Newberry
• Oakley Pharmacy Inc (Dale Hollow Pharmacy)
• Anitra Ostos, RN
• Ronnie Raines, NP

• Family Medicine Physician in Celina, TN
• Providers in Celina, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2026; 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.