Individual provider Active NPI

Ann C. Roberson, M.D.

  • Anesthesiology Physician
  • Jackson, MS
National Provider Identifier
1265688865
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
22093 Issued in MS
Practice address
1151 N. State St.
Suite 311
Jackson, MS 39202
Phone
(601) 969-1171
Fax
(601) 969-1173
NPI assigned
Aug 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X T2132 MS
Anesthesiology Physician 207L00000X 22093 MS Primary

Addresses

Primary practice location

1151 N. State St.
Suite 311
Jackson, MS 39202

Mailing address

1151 N. State St.
Suite 311
Jackson, MS 39202
Phone (601) 969-1171

Other names 1

  • Ann C. Walker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T2132MSMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Anesthesia Associates PA Anesthesiology PastSince Jul 29, 2012 Accepting new patients
Jackson Pain Center PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1265688865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N. STATE ST.",
            "address_2": "SUITE 311",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39202",
            "telephone_number": "601-969-1171",
            "fax_number": "601-969-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N. STATE ST.",
            "address_2": "SUITE 311",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39202",
            "telephone_number": "601-969-1171",
            "fax_number": "601-969-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "ANN",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "T2132",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "22093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "WALKER",
            "middle_name": "C.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.