Individual provider Active NPI

Erin Kathryn Roberts, D.O.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1417202920
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02004738A Issued in IN
Practice address
2233 W Division St
Chicago, IL 60622-8151
Phone
(312) 770-2128
NPI assigned
Jul 20, 2012
Last updated
Mar 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.062248 IL
Family Medicine Physician 207Q00000X 02004738A IN Primary

Addresses

Primary practice location

2233 W Division St
Chicago, IL 60622-8151

Mailing address

8400 Louisiana St
Merrillville, IN 46410-6385
Phone (219) 757-1928

Other practice location 1

559 State St
Hammond, IN 46320-1533
Phone (219) 937-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eroberts21084@ce-direct.presencehealth.org

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125.062248ILMDFamily Medicine Physician
02004738AINMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: eroberts21084@ce-direct.presencehealth.org

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1417202920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 LOUISIANA ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106385",
            "telephone_number": "219-757-1928",
            "fax_number": "219-757-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228151",
            "telephone_number": "312-770-2128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "559 State St",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "IN",
            "postal_code": "463201533",
            "country_code": "US",
            "telephone_number": "219-937-3300",
            "fax_number": "219-803-7252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ERIN",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.062248",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02004738A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eroberts21084@ce-direct.presencehealth.org",
            "affiliation": "N",
            "address_1": "2233 W Division St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606228151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.