David L Roberts, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

781 Issued in OK

Practice address

2110 N Broadway St
Poteau
Poteau, OK 74953-2501

Phone

(918) 647-3284

Fax

(918) 647-3394

NPI assigned

Sep 30, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1427045921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 829",
            "address_2": "POTEAU",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749530829",
            "telephone_number": "918-647-3284",
            "fax_number": "918-647-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 N BROADWAY ST",
            "address_2": "POTEAU",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749532501",
            "telephone_number": "918-647-3284",
            "fax_number": "918-647-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE STANDARD",
            "identifier": "731508474953A001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100761880A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• River Valley Women's Care LLC
• River Vally Counseling
• Rivermark Physical Therapy, Inc
• Aleisha Roberts
• Darian Roberts
• Jessie Nicole Roberts, LPC
• Carla Beth Robertson, IBCLC
• Suzanne Kay Rodgers, APN
• Johnny R Rodriguez, D.O.
• Ronald N Hesser DDS PC

• Optometrist in Poteau, OK
• Providers in Poteau, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.