Carysia Roberts, LAB DIRECTOR

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

Practice address

720 W 5TH Ave
Gary, IN 46402-1808

Phone

(219) 248-4912

NPI assigned

Jan 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Healthcare Port

  • Phlebotomy Technician
  • Gary, IN
  • NPI 1831844539

  Multi-Specialty

  NPD Authorized official

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1295496578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 MARYLAND ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464022545",
            "telephone_number": "219-248-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W 5TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021808",
            "telephone_number": "219-248-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CARYSIA",
        "credential": "LAB DIRECTOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOVERMENT",
            "identifier": "1984",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1984",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOVERMENT",
            "identifier": "1984",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1984",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Richardson
• Lela Jane Riordan, COTA
• Ricardo Rivera-Yagnich, M.D.
• Rachel Rivers, L. AC.
• Robert W Moses OD Professional Corp.
• D-Angelo Robertson
• Thessa Grace Robertson, MD
• Robinson Adult Day Services Inc
• Amanda Robinson
• Clarease Robinson, OTR/L

• Clinical Laboratory Director (Non-physician) in Gary, IN
• Providers in Gary, IN by specialty
• Clinical Laboratory Director (Non-physician) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.