Individual provider Active NPI

Lloyd Ray Roberts, RN

  • Community Health Registered Nurse
  • Fort Worth, TX
National Provider Identifier
1306025879
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
584240 Issued in TX
Practice address
4216 Sarita Drive
Fort Worth, TX 76109
Phone
(817) 980-5521
Fax
(817) 923-3505
NPI assigned
Oct 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 584240 TX Primary

Addresses

Primary practice location

4216 Sarita Drive
Fort Worth, TX 76109

Mailing address

4216 Sarita Drive
Fort Worth, TX 76109
Phone (817) 980-5521

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
584240TXMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1306025879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4216 SARITA DRIVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-980-5521",
            "fax_number": "817-923-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 SARITA DRIVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-980-5521",
            "fax_number": "817-923-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LLOYD",
        "middle_name": "RAY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TX",
            "license": "584240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.