Active NPI
Jomar Roberts
- Neurology Physician
- Salisbury, NC
National Provider Identifier
1295904993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 2017-02581
- Practice address
- 612 Mocksville Ave
Salisbury, NC 28144-2732 - Phone
- (704) 637-1779
- Fax
- (704) 637-1121
- NPI assigned
- Feb 27, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 32821 | SC | |
| Neurology Physician | 2084N0400X | 2017-02581 | NC | Primary |
Addresses
Primary practice location
612 Mocksville Ave
Salisbury, NC 28144-2732
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 637-1779
Other practice location 1
1010 Edgehill Rd N
Charlotte, NC 28207-1885
Phone (704) 446-1900
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2017-02581 | NC | MD | Neurology Physician |
| 32821 | SC | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palmetto Professional Speech Therapy Services LLC | Past | Accepting new patients | |
| Coastal Carolina Multispecialty Associates, LLC | Past | Accepting new patients | |
| Carolina Speech Therapy Associates SC,Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Speech-Language Pathologist
- Sumter, SC
- NPI 1114245057
-
- Specialist
- Summerville, SC
- NPI 1518079102
-
- Speech-Language Pathologist
- Gable, SC
- NPI 1376991687
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579132800000",
"number": "1295904993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447",
"telephone_number": "704-637-1779",
"fax_number": "704-637-1121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 MOCKSVILLE AVE",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281442732",
"telephone_number": "704-637-1779",
"fax_number": "704-637-1121"
}
],
"practiceLocations": [
{
"address_1": "1010 Edgehill Rd N",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282071885",
"country_code": "US",
"telephone_number": "704-446-1900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTS",
"first_name": "JOMAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-27",
"last_updated": "2020-01-16",
"certification_date": "2020-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "SC",
"license": "32821",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NC",
"license": "2017-02581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.