Active NPI
Michelle Lea Roberts, RN
- Adult Psychiatric/Mental Health Registered Nurse
- Marion, IL
National Provider Identifier
1437318045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- License
- 28139603A
- Practice address
- 2401 W Main St
BLDG 8
Marion, IL 62959-1188 - Phone
- (618) 993-4117
- Fax
- (618) 998-5668
- NPI assigned
- Jun 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | 28139603A | IN | Primary |
Addresses
Primary practice location
2401 W Main St
BLDG 8
Marion, IL 62959-1188
Mailing address
2401 W Main St
BLDG 8
Marion, IL 62959-1188
Phone (618) 993-4117
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28139603A | IN | MD | Adult Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1437318045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 W MAIN ST",
"address_2": "BLDG 8",
"city": "MARION",
"state": "IL",
"postal_code": "629591188",
"telephone_number": "618-993-4117",
"fax_number": "618-998-5668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 W MAIN ST",
"address_2": "BLDG 8",
"city": "MARION",
"state": "IL",
"postal_code": "629591188",
"telephone_number": "618-993-4117",
"fax_number": "618-998-5668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "MICHELLE",
"middle_name": "LEA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-09",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "IN",
"license": "28139603A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.