Individual provider Active NPI

Frank Clifford Roberson, M.D.

  • Neurological Surgery Physician
  • Corvallis, OR
National Provider Identifier
1306976022
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD11838 Issued in OR
Practice address
3615 NW Samaritan Dr
Suite 210
Corvallis, OR 97330-3783
Phone
(541) 768-5210
Fax
(541) 768-5211
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD11838 OR Primary

Addresses

Primary practice location

3615 NW Samaritan Dr
Suite 210
Corvallis, OR 97330-3783

Mailing address

3615 NW Samaritan Dr
Suite 210
Corvallis, OR 97330-3783
Phone (541) 768-5210

Other identifiers 1

IdentifierTypeStateIssuer
227410MedicaidOR

Other names 1

  • Dr. F. Clifford Roberson Professional name

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

LicenseStateTypeSpecialty
MD11838ORMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis Past Accepting new patients
Firstcare Medical Foundation Neurological Surgery PastSince Sep 1, 2004 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306976022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 NW SAMARITAN DR",
            "address_2": "SUITE 210",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303783",
            "telephone_number": "541-768-5210",
            "fax_number": "541-768-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 NW SAMARITAN DR",
            "address_2": "SUITE 210",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303783",
            "telephone_number": "541-768-5210",
            "fax_number": "541-768-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "FRANK",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OR",
            "license": "MD11838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227410",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "F.",
            "last_name": "ROBERSON",
            "middle_name": "CLIFFORD",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.