Individual provider Active NPI

John Martin Roberts, MD

  • Psychiatry Physician
  • Davidson, NC
National Provider Identifier
1417020165
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
9500438 Issued in NC
Practice address
104 Knox CT Ste 100
Davidson, NC 28036-0590
Phone
(704) 892-5454
Fax
(704) 892-5858
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 9500438 NC Primary
Psychiatry Physician 2084P0800X 13892 SC

Addresses

Primary practice location

104 Knox CT Ste 100
Davidson, NC 28036-0590

Mailing address

4705 University Dr BLDG 700
Durham, NC 27707-3489
Phone (704) 892-3320

Other practice location 1

5821 Fairview Rd Ste 200
Charlotte, NC 28209-3649
Phone (980) 580-0639

Other identifiers 1

IdentifierTypeStateIssuer
139825MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240405002092 NC Practitioner - PsychiatryPractitioner - Neurology 7113813916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Louisiana State University School of Medicine in Shreveport, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avance Care PAGroup PAC ID 3577634476, 244 clinicians
Fletcher Hospital IncGroup PAC ID 5395658819, 302 clinicians

Practice addresses (Care Compare)

104 Knox CT
Suite 100
Davidson, NC 28036-0590
Phone (704) 892-5454

50 Hospital Dr
Suite 5a
Hendersonville, NC 28792-5247
Phone (828) 684-1115

Hospital & facility affiliations

  • Adventhealth Hendersonville Hospital, Hendersonville, NC, CCN 340023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13892SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Aug 1, 2025 Accepting new patients
Fletcher Hospital Inc. Current Accepting new patients
Fletcher Hospital Inc. Psychiatry CurrentSince Feb 21, 2024 Accepting new patients
Fletcher Hospital Inc CurrentSince Feb 21, 2024 Accepting new patients

Locations

4705 University Dr
Bldg 700
Durham, NC 27707
Phone (919) 237-1337

50 Hospital Dr
Ste 5A
Hendersonville, NC 28792
Phone (828) 684-1115

80 Doctors Dr
Ste 1
Hendersonvlle, NC 28792
Phone (282) 654-0073

7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880

Interoperability endpoints

  • Direct secure messaging: jroberts2559601@adventhealth.direct-ci.com

Organizations & group practices 4

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 2

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1417020165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "704-892-3320",
            "fax_number": "704-780-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 KNOX CT STE 100",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280360590",
            "telephone_number": "704-892-5454",
            "fax_number": "704-892-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5821 Fairview Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282093649",
            "country_code": "US",
            "telephone_number": "980-580-0639",
            "fax_number": "980-580-0507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JOHN",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9500438",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "13892",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139825",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

Verify at the official NPI Registry.