Active NPI
Sandra D Roberts, MS, RD
- Registered Dietitian
- Galloway, NJ
National Provider Identifier
1295966208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 800038
- Practice address
- 408 E Jimmie Leeds Rd
Galloway, NJ 08205-9706 - Phone
- (609) 625-6947
- NPI assigned
- Aug 7, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 800038 | NJ | Primary |
Addresses
Primary practice location
408 E Jimmie Leeds Rd
Galloway, NJ 08205-9706
Mailing address
65 Lacosta Dr
Egg Harbor TWP, NJ 08234-5854
Phone (609) 653-4475
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 800038 | NJ | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404518400000",
"number": "1295966208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 LACOSTA DR",
"city": "EGG HARBOR TWP",
"state": "NJ",
"postal_code": "082345854",
"telephone_number": "609-653-4475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "408 E JIMMIE LEEDS RD",
"city": "GALLOWAY",
"state": "NJ",
"postal_code": "082059706",
"telephone_number": "609-625-6947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "SANDRA",
"middle_name": "D",
"name_prefix": "Mrs.",
"credential": "MS, RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-07",
"last_updated": "2014-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NJ",
"license": "800038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Galloway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.