Kelly Sarah Roberts, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704296758 Issued in MI

Practice address

1600 S Canton Center Rd Ste 200
Canton, MI 48188

Phone

(734) 398-5229

Fax

(734) 398-5228

NPI assigned

Nov 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1306388715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S CANTON CENTER RD STE 200",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481886276",
            "telephone_number": "734-398-5229",
            "fax_number": "734-398-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S CANTON CENTER RD STE 200",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48188",
            "telephone_number": "734-398-5229",
            "fax_number": "734-398-5228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5515 Cleveland Ave",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Stevensville",
            "state": "MI",
            "postal_code": "491279670",
            "country_code": "US",
            "telephone_number": "269-429-6604",
            "fax_number": "269-429-1715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5515 Cleveland Ave",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Stevensville",
            "state": "MI",
            "postal_code": "491279670",
            "country_code": "US",
            "telephone_number": "269-429-6604",
            "fax_number": "269-429-1715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KELLY",
        "middle_name": "SARAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704296758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Elizabeth Roach
• Robert Daniel Travis, M.D., PC
• Robert Edward Potter Jr DC PLLC
• Robert I. Lubin, D.P.M., P. L.L.C
• Robert I. Lubin, D.P.M., P. L.L.C
• Emily Ann Robertson, PA
• Lily Therese Robertson
• Robin L Skora LPC, LLC
• Anthony Robinson, CCC-SLP
• Briana Lashawn Robinson

• Pediatric Nurse Practitioner in Canton, MI
• Providers in Canton, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.