Randy D Roberts MD PA

Key facts

NPI

1245208503

Entity type

Organization (NPI type 2)

Primary specialty

Rheumatology Physician 207RR0500X

License

N6752 (AR)

Legal business name

RANDY D ROBERTS MD PA

Practice address

1000C East Matthews
Jonesboro, AR 72401

Phone

(870) 268-8880

Fax

(870) 268-8882

NPI assigned

Mar 10, 2006

Organization subpart

No

Authorized official

Name

Randy D Roberts, MD NPI 1447228663

Title

MD

Phone

(870) 268-8880

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randy D Roberts, MD Rheumatology Physician · Jonesboro, AR · NPI 1447228663
  Medicare reassignment NPD Authorized official AR · RHEUMATOLOGY

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare participation

Medicare fee-for-service enrollment

Enrolled in AR

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 16, 2013.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1245208503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000C EAST MATTHEWS",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-268-8880",
            "fax_number": "870-268-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000C EAST MATTHEWS",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-268-8880",
            "fax_number": "870-268-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY D ROBERTS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "870-268-8880",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AR",
            "license": "N6752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110866001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

• Jordan Ramm, PTA
• Amanda Ramsey
• Christopher Jacob Ramsey, L.A.C.
• Jeffrey W Ramsey, P.T.
• Barbara Clements Rand
• Lynlee Rankin
• Sharonaka Ransom
• William Rath, ATC, LAT
• Jacob Rathbun
• Kalie D Rathbun

All providers in Jonesboro, AR · Rheumatology Physician in Arkansas