Jennifer Sue Roberts, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

125.053318 Issued in IL

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Phone

(309) 655-2000

NPI assigned

Jul 18, 2007

Sex

Female

Sole proprietor

Yes

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 MO, IL2 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

Specialty

Emergency Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Graham Hospital Association Hospital, Canton, IL, CCN 140001
• Graham Hospital Association Hospital, Canton, IL, CCN 141356

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1780692087
  Medicare reassignment Care Compare group NPD
• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947

  Emergency Medicine

  Medicare reassignment NPD
• Epss LLC - Central Series

  • Emergency Medicine Physician
  • Pekin, IL
  • NPI 1538680467
  Medicare reassignment NPD
• Epss Peoria LLC

  • Emergency Medicine Physician
  • Peoria, IL
  • NPI 1831421056
  Medicare reassignment NPD
• Epss, LLC- Metro Series

  • Emergency Medicine Physician
  • Peoria, IL
  • NPI 1124782305
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • Emergency Care Clinic/Center
  • Peoria, IL
  • NPI 1265966048
  Medicare reassignment NPD
• Pekin Memorial Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Pekin, IL
  • NPI 1245355411
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Graham Hospital Association

  • Internal Medicine Physician
  • Galesburg, IL
  • NPI 1710845854
  NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  NPD
• Pekin Memorial Hospital

  • General Acute Care Hospital
  • Pekin, IL
  • NPI 1245227479
  NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  NPD

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

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1154117521
  Care Compare affiliation

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1417157546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 W SHERMAN AVE",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "616045460",
            "telephone_number": "309-453-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JENNIFER",
        "middle_name": "SUE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.053318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert R Zinser DC & Assoc PC
• Aleetra Roberts, MD
• Brad Roberts, DO
• Dawn C Roberts, PHD
• Jeffrey B Roberts, P.A.
• Jonathan Charles Roberts, M.D.
• Micah A Roberts, DMD
• Shannon Marie Roberts, APRN
• Sarah Katherine Robertson, MA
• John Michael Robins, MD

• Emergency Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.