Individual provider Active NPI

Charles Roberts, MD

  • Interventional Pain Medicine Physician
  • Crestview Hills, KY
National Provider Identifier
1366456162
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
48818 Issued in KY
Practice address
2845 Chancellor Dr
Crestview Hills, KY 41017-3418
Phone
(859) 301-2663
Fax
(859) 817-7848
NPI assigned
Jul 28, 2006
Last updated
Jun 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 48818 KY
Anesthesiology Physician 207L00000X D69123 MD
Addiction Medicine (Anesthesiology) Physician 207LA0401X D69123 MD
Pain Medicine (Anesthesiology) Physician 207LP2900X 48818 KY
Interventional Pain Medicine Physician 208VP0014X 48818 KY Primary
Hospice and Palliative Medicine (Anesthesiology) Physician 207LH0002X D69123 MD

Addresses

Primary practice location

2845 Chancellor Dr
Crestview Hills, KY 41017-3418

Mailing address

560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151021001057 KY Practitioner - Pain ManagementPractitioner - Anesthesiology 4789700782 Reassigns benefits to 4 organizations
I20260109000396 IN Practitioner - Anesthesiology 4789700782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Virginia Commonwealth University, School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Group Practice IncGroup PAC ID 1254245137, 396 clinicians
Pain Specialists of Cincinnati LLCGroup PAC ID 3870809023, 6 clinicians
Regenlife CenterGroup PAC ID 4385179142, 10 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2000

162 Barnwood Dr
Edgewood, KY 41017-2501
Phone (859) 331-4159

600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (812) 537-1010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D69123MDMDHospice and Palliative Medicine (Anesthesiology) Physician
48818KYMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hansen Pain and Wellness CurrentSince Jul 7, 2024 Accepting new patients
Anesthesia Group Practice, Inc Anesthesiology CurrentSince Jun 10, 2023 Accepting new patients
Pain Specialists of Cincinnati, LLC CurrentSince Apr 1, 2024 Accepting new patients
Regenlife Center CurrentSince Dec 13, 2024 Accepting new patients
Frederick Health Hospital Inc Interventional Pain Medicine Past Accepting new patients

Locations

600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700

2845 Chancellor Dr
Crestview Hills, KY 41017
Phone (859) 341-3412

340 Thomas More Pkwy
Ste 260
Crestview Hills, KY 41017
Phone (859) 957-0700

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

162 Barnwood Dr
Edgewood, KY 41017
Phone (859) 331-4159

Interoperability endpoints

  • Direct secure messaging: croberts187088@direct-prd.stelizabeth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1366456162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173405",
            "telephone_number": "859-301-2663",
            "fax_number": "859-817-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 CHANCELLOR DR",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173418",
            "telephone_number": "859-301-2663",
            "fax_number": "859-817-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "48818",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D69123",
            "primary": false
        },
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "MD",
            "license": "D69123",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "KY",
            "license": "48818",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "KY",
            "license": "48818",
            "primary": true
        },
        {
            "code": "207LH0002X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Hospice and Palliative Medicine",
            "state": "MD",
            "license": "D69123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

Verify at the official NPI Registry.