J. Gregory Roberts MD RVT

Primary specialty

SpecialistTaxonomy code 174400000X

License

37706 Issued in TN

Legal business name

J. GREGORY ROBERTS MD RVT

Practice address

10810 Parkside Dr
Suite 309
Knoxville, TN 37934-1979

Phone

(865) 218-6244

Fax

(865) 218-6245

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. James Gregory Roberts, MD RVT FACS

Title

Physician

Phone

(865) 218-6244

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Mantle Clinic III Doing business as

Tax ID family

J Gregory Roberts MD RVT3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• J. Gregory Roberts MD RVT

  • Specialist
  • Oneida, TN
  • NPI 1629103635
  NPD tax ID
• J. Gregory Roberts, MD, RVT, PC Dba Mantle Clinic III

  • Specialist
  • Knoxville, TN
  • NPI 1609075464
  NPD tax ID

Locations

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1356486252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 FALCON POINTE DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379226397",
            "telephone_number": "865-438-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 PARKSIDE DR",
            "address_2": "SUITE 309",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341979",
            "telephone_number": "865-218-6244",
            "fax_number": "865-218-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. GREGORY ROBERTS MD RVT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "865-218-6244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD RVT FACS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "37706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4069830",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY NUMBER",
            "identifier": "$$$$$$$$$",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY MEDICAID",
            "identifier": "64078132",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA9327",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mantle Clinic III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jocelyn Ivy, LPC-MHSP
• Michael Ray Ivy
• J Benjamin Rivers DMD PC
• J. C. Dow, Inc.
• J. Caroline Haney-Weaver, M.D.
• J. Gregory Roberts, MD, RVT, PC Dba Mantle Clinic III
• J. Sidney Alexander, M.D., P.C.
• J.T. Major DDS PC
• J.W. Carell Enterprises, LLC
• J&R Transportation

• Specialist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.