Active NPI
Rebecca A Roberts, APRN
- Nurse Practitioner
- Manchester, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3008071
- Practice address
- 86 Highway 638
Suite 1
Manchester, KY 40962-7289 - Phone
- (606) 596-0701
- Fax
- (606) 596-0703
- NPI assigned
- Jun 6, 2013
- Last updated
- Mar 27, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3008071 | KY | Primary |
| Family Nurse Practitioner | 363LF0000X | 3008071 | KY |
Addresses
Primary practice location
86 Highway 638
Suite 1
Manchester, KY 40962-7289
Mailing address
PO Box 737
Booneville, KY 41314-0737
Phone (606) 593-6023
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100258650 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
108 Manchester Shopping Ctr
Manchester, KY 40962-1401
Phone (606) 658-6333
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3008071 | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Practice Clinic of Booneville, Inc. | Current | Accepting new patients | |
| Mountain Family Practice Clinic of Manchester Inc | Current | Accepting new patients | |
| Lancaster Family Health Care | Nurse Practitioner | Current | Accepting new patients |
| Grace Community Health Center, Inc. | Past | Accepting new patients |
Locations
200 Mulberry St
#A
Booneville, KY 41314
Phone (606) 596-0701
108 Lexington St
Lancaster, KY 40444
Phone (859) 304-5258
108 Manchester Shopping Ctr
Manchester, KY 40962
Phone (606) 596-0701
86 Highway 638
#1
Manchester, KY 40962
Phone (606) 596-0701
Interoperability endpoints
- https://api.platform.athenahealth.com/3044/brand/1/csg/1/fhir/r4
- rebecca.roberts@kbcc.eclinicaldirectplus.com
Organizations & group practices 4
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.
-
- Rural Health Clinic/Center
- Manchester, KY
- NPI 1689919078
-
- Rural Health Clinic/Center
- Booneville, KY
- NPI 1326152109
-
- Rural Health Clinic/Center
- Lancaster, KY
- NPI 1942946710
Nurse Practitioner
-
dba Grace Health
- Federally Qualified Health Center (FQHC)
- Corbin, KY
- NPI 1316645344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395878400000",
"number": "1285072751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 737",
"city": "BOONEVILLE",
"state": "KY",
"postal_code": "413140737",
"telephone_number": "606-593-6023",
"fax_number": "606-593-6087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "86 HIGHWAY 638",
"address_2": "SUITE 1",
"city": "MANCHESTER",
"state": "KY",
"postal_code": "409627289",
"telephone_number": "606-596-0701",
"fax_number": "606-596-0703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "REBECCA",
"middle_name": "A",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-06",
"last_updated": "2014-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3008071",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3008071",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100258650",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Manchester, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.