Nicholas Ryan Roberts, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

322986 Issued in LA

Practice address

1501 Kings Highway
Emergency Medicine
Shreveport, LA 71130

Phone

(318) 626-1034

NPI assigned

Apr 2, 2018

Last updated

Jul 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Emergency Medicine

Education

Louisiana State University School of Medicine in Shreveport, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cross Lake Emergency Group, LLCGroup PAC ID 5395096440, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Cross Lake Emergency Group, LLC

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1013497114
  Medicare reassignment Care Compare group NPD
• Coushatta ER Physicians

  • Emergency Medicine Physician
  • Coushatta, LA
  • NPI 1427480680
  Medicare reassignment NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222

  Emergency Medicine

  Medicare reassignment NPD
• Nes Louisiana Inc

  • Emergency Medicine Physician
  • Natchitoches, LA
  • NPI 1669922431
  Medicare reassignment NPD
• Oakdale Ess LLC

  • Emergency Medicine Physician
  • Oakdale, LA
  • NPI 1750785119
  Medicare reassignment NPD
• Nes Louisiana Inc

  • Emergency Medicine Physician
  • Springhill, LA
  • NPI 1649867789
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1205332053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HIGHWAY",
            "address_2": "EMERGENCY MEDICINE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71130",
            "telephone_number": "318-626-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HIGHWAY",
            "address_2": "EMERGENCY MEDICINE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71130",
            "telephone_number": "318-626-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "322986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal L Roberts, MA, LPC
• Gary L Roberts, DDS
• Jennifer Roberts
• Juanita Carolyn Roberts, MSN, APRN, PMHNP-BC
• Madysen Paige Roberts
• Russell Wayne Roberts, M.D.
• Tiffany Marie Roberts
• Yolanda A Roberts
• Diane Robertson-Dawson, LMSW
• Cathy Lynn Robertson, APRN

• Emergency Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Emergency Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.

Verify at the official NPI Registry.