Active NPI
Michael Garrett Roberts Sr.
- Pharmacist
- Cleburne, TX
National Provider Identifier
1396340949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18435
- Practice address
- 614 W Henderson St
Cleburne, TX 76033-4848 - Phone
- (817) 645-2419
- NPI assigned
- Dec 2, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18435 | TX | Primary |
Addresses
Primary practice location
614 W Henderson St
Cleburne, TX 76033-4848
Mailing address
614 W Henderson St
Cleburne, TX 76033-4848
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | RXConnect |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18435 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | 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": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1396340949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 W HENDERSON ST",
"city": "CLEBURNE",
"state": "TX",
"postal_code": "760334848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 W HENDERSON ST",
"city": "CLEBURNE",
"state": "TX",
"postal_code": "760334848",
"telephone_number": "817-645-2419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "MICHAEL",
"middle_name": "GARRETT",
"name_suffix": "Sr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-02",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "18435",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "RXConnect",
"affiliation": "N",
"address_1": "614 W Henderson St",
"city": "Cleburne",
"state": "TX",
"country_code": "US",
"postal_code": "760334848",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cleburne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.