Kelvin R Roberts, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1707 N 12TH St
Quincy, IL 62301-1355

Phone

(217) 222-9487

Fax

(217) 222-8578

NPI assigned

Oct 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Illinois Veterans Home at Quincy

  • Physical Disabilities Residential Treatment Facility
  • Quincy, IL
  • NPI 1386708568
  Medicare reassignment

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1407045776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 N 12TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623011355",
            "telephone_number": "217-222-9487",
            "fax_number": "217-222-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 N 12TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623011355",
            "telephone_number": "217-222-9487",
            "fax_number": "217-222-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KELVIN",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-23",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Riutzel, LCSW
• Rivercross Diagnostics Inc. (Rivercross Diagnostics)
• Rivercross Diagnostics, LLC (Rivercross Diagnostics)
• Robert E. Merrick PC
• Jennifer Roberts
• Wade Roberts, DPT, PT
• Shari W Robesky, LCSW
• Michelle Beth Robison, MSW.,LCSW
• Yvonne Robison
• Sara Rodeffer, D.M.D

• Clinical Social Worker in Quincy, IL
• Providers in Quincy, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.