Audrey J Roberts MD PLLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

AUDREY J ROBERTS MD PLLC

Practice address

1100 N San Francisco St Ste B
Flagstaff, AZ 86001-3260

Phone

(928) 779-7851

Fax

(928) 213-9990

NPI assigned

Apr 19, 2022

Organization subpart

No

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

Authorized official

Name

Audrey Roberts, MD

Title

Owner

Phone

(419) 306-9499

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1295478956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N SAN FRANCISCO ST STE B",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013260",
            "telephone_number": "928-779-7851",
            "fax_number": "928-213-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N SAN FRANCISCO ST STE B",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013260",
            "telephone_number": "928-779-7851",
            "fax_number": "928-213-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDREY J ROBERTS MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-306-9499",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3003228",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.