Individual provider Active NPI

Rebecca A Roberts, APRN

  • Nurse Practitioner
  • Manchester, KY
National Provider Identifier
1285072751
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3008071 Issued in KY
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, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
7100258650MedicaidKY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130726000624 KY Practitioner - Nurse Practitioner 8628219094 Reassigns benefits to 3 organizations

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
Mountain Family Practice Clinic of Manchester IncGroup PAC ID 0143465617, 16 clinicians

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

LicenseStateTypeSpecialty
3008071KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Clinic of Booneville, Inc. CurrentSince Jan 25, 2014 Accepting new patients
Mountain Family Practice Clinic of Manchester Inc CurrentSince Jun 5, 2013 Accepting new patients
Lancaster Family Health Care Nurse Practitioner CurrentSince Dec 27, 2023 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

  • FHIR API: https://api.platform.athenahealth.com/3044/brand/1/csg/1/fhir/r4
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.