Individual provider Active NPI

Alicia Roberts Register, MD

  • Surgery Physician
  • Cordele, GA
National Provider Identifier
1356789473
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
81486 Issued in GA
Practice address
1329 N 5TH Street Ext
Cordele, GA 31015-3753
Phone
(229) 273-9050
NPI assigned
Jun 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 6087 GA
Surgery Physician 208600000X 81486 GA Primary

Addresses

Primary practice location

1329 N 5TH Street Ext
Cordele, GA 31015-3753

Mailing address

1329 N 5TH Street Ext
Cordele, GA 31015-3753
Phone (229) 273-9050

Other practice location 1

902 N 7th St
Cordele, GA 31015-3234
Phone (229) 276-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190918001283 GA Practitioner - General Surgery 9739400839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Georgia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crisp Regional Hospital IncGroup PAC ID 5991616336, 65 clinicians

Practice addresses (Care Compare)

902 N 7TH St
Cordele, GA 31015-3234
Phone (229) 276-3100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6087GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crisp Regional Hospital, Inc CurrentSince Jul 19, 2019 Accepting new patients
Crisp Regional Hospital Inc CurrentSince Jul 19, 2019 Accepting new patients

Locations

902 N 7th St
Cordele, GA 31015
Phone (229) 276-3100

1329 N 5th Street Ext
Cordele, GA 31015
Phone (229) 273-6939

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1356789473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 N 5TH STREET EXT",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153753",
            "telephone_number": "229-273-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 N 5TH STREET EXT",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153753",
            "telephone_number": "229-273-9050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Cordele",
            "state": "GA",
            "postal_code": "310153234",
            "country_code": "US",
            "telephone_number": "229-276-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REGISTER",
        "first_name": "ALICIA",
        "middle_name": "ROBERTS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "6087",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "81486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordele, GA

Sources for this page

Verify at the official NPI Registry.