Organization Active NPI

Roberts Orthotics & Prosthetics

  • Prosthetic/Orthotic Supplier
  • Waynesburg, PA
National Provider Identifier
1417912668
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
ROBERTS ORTHOTICS & PROSTHETICS
Practice address
244 Elm Dr
Suite 104
Waynesburg, PA 15370-8269
Phone
(724) 627-4600
Fax
(724) 627-4606
NPI assigned
Apr 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Authorized official

Name
Mr. Jeffrey L. Roberts, BOCOP
Title
Owner
Phone
(724) 627-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

244 Elm Dr
Suite 104
Waynesburg, PA 15370-8269

Mailing address

244 Elm Dr
Suite 104
Waynesburg, PA 15370-8269
Phone (724) 627-4600

Other identifiers 4

IdentifierTypeStateIssuer
123485MedicaidPA
219555OtherPABLUE CROSS/BLUE SHIELD
001823780002MedicaidPA
6204003000MedicaidWV

National Provider Directory

National Provider Directory

Locations

107 E Roy Furman Hwy
Ste 104
Waynesburg, PA 15370
Phone (724) 627-4600

244 Elm Dr
Waynesburg, PA 15370
Phone (724) 627-4600

244 Elm Dr
Ste 104
Waynesburg, PA 15370
Phone (724) 627-4600

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1417912668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 ELM DR",
            "address_2": "SUITE 104",
            "city": "WAYNESBURG",
            "state": "PA",
            "postal_code": "153708269",
            "telephone_number": "724-627-4600",
            "fax_number": "724-627-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 ELM DR",
            "address_2": "SUITE 104",
            "city": "WAYNESBURG",
            "state": "PA",
            "postal_code": "153708269",
            "telephone_number": "724-627-4600",
            "fax_number": "724-627-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTS ORTHOTICS & PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-627-4600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BOCOP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123485",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "219555",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001823780002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6204003000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.