Roberta J Carr, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA287 Issued in ID

Practice address

111 Bever Grade
Lapwai, ID 83540-0367

Phone

(208) 843-2271

Fax

(208) 843-2658

NPI assigned

Aug 9, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Gritman Medical Center Inc

  • Critical Access Hospital
  • Moscow, ID
  • NPI 1619988144

  ID

  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1598814352

  WA

  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221

  WA

  Medicare reassignment NPD
• Gritman Medical Center, Inc.

  • Family Medicine Physician
  • Moscow, ID
  • NPI 1538634522

  ID

  Medicare reassignment
• Hospitalist Medicine Physicians of Idaho- Nampa PLLC

  • Emergency Medicine Physician
  • Lewiston, ID
  • NPI 1558995316

  ID

  Medicare reassignment
• Gritman Medical Center Inc.

  • Clinic/Center
  • Moscow, ID
  • NPI 1790182590
  NPD
• Gritman Medical Center, Inc.

  • Family Medicine Physician
  • Lewiston, ID
  • NPI 1588413694
  NPD
• Tri-State Memorial Hospital

  • Community Based Hospice Care Agency
  • Clarkston, WA
  • NPI 1831100254
  NPD

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1306856547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "LAPWAI",
            "state": "ID",
            "postal_code": "835400367",
            "telephone_number": "208-843-2271",
            "fax_number": "208-843-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BEVER GRADE",
            "city": "LAPWAI",
            "state": "ID",
            "postal_code": "835400367",
            "telephone_number": "208-843-2271",
            "fax_number": "208-843-2658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 W A St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838436000",
            "country_code": "US",
            "telephone_number": "208-882-0540",
            "fax_number": "208-883-1853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR",
        "first_name": "ROBERTA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805010100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonia Aripa, LMSW
• Dora L Axtell, LCSW
• Andrea Renee Bentz, RT R
• Linda D Busch, RN, CPEDORTHIST
• Constancio L Cleto, MT
• James Lewis Collier, RT ARRT MA BS AS
• Marie Jeanette Cooper, LPN
• Tyler Cowart, PHARMD
• Consuelo Mercado Cruz, MED TECH

• All providers in Lapwai, ID
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.