Mia Wallin Roberts, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APN.0990539-NP Issued in CO

Practice address

4107 S Federal Blvd Ste B
Englewood, CO 80110-4316

Phone

(303) 315-6150

NPI assigned

Jan 3, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mia.roberts@shs.directbygreenway.com

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.

• University of Colorado

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Denver, CO
  • NPI 1477553014
  NPD (past)

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1245651512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13120 E 19TH AVE C288-5",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80045",
            "telephone_number": "303-724-8555",
            "fax_number": "303-724-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 S FEDERAL BLVD STE B",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801104316",
            "telephone_number": "303-315-6150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1936 Magazine St",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701305016",
            "country_code": "US",
            "telephone_number": "504-529-5558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MIA",
        "middle_name": "WALLIN",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "AP07790",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "APN.0990539-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert E Pelc PHD Abpp Professional Corporation
• Caitlin Roberts
• Codie Marie Roberts, DPT
• Gregory James Roberts, CNM
• Laura Michele Roberts, MS, PA-C
• Soo Roberts, RN
• Jacob Andrew Robertson, PA-C
• Linda K Robertson
• Troy Robey, ED M
• Amanda C Robichaud, CFA

• Pediatric Nurse Practitioner in Englewood, CO
• Providers in Englewood, CO by specialty
• Pediatric Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.