Jo Ellen Roberson, RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

106404 Issued in SC

Practice address

2100 Bull St
Columbia, SC 29201

Phone

(251) 415-1496

Fax

(251) 415-8601

NPI assigned

Jun 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jo Ellen Roberson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Registered Nurse

State licenses

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1427369685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 BULL ST.",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "251-415-1496",
            "fax_number": "251-415-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 BULL ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "251-415-1496",
            "fax_number": "251-415-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "JO",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AL",
            "license": "1-058198",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "SC",
            "license": "106404",
            "primary": true
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "OR",
            "license": "201400106RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JO",
            "last_name": "ROBERSON",
            "middle_name": "ELLEN",
            "credential": "APRN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brandon Lars Roberg, PH.D.
• Caroljane Blanchard Roberson, M.D.
• Cristina H Roberson, LISW
• Detris Lashall Roberson, APRN
• Jade E. Roberson, RBT
• Sabria Roberson
• Tawana Naydean Roberson, DC
• Tyrone G Roberson Sr., AGPCNP-BC
• Uniqa Sade Roberson, RN
• Robert L. Waldron, II, MD, PA

• Administrator Registered Nurse in Columbia, SC
• Providers in Columbia, SC by specialty
• Administrator Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.