Mayory Roberts, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71010982A Issued in IN

Practice address

1828 165TH St Ste a
Hammond, IN 46320-2823

Phone

(219) 763-8112

Fax

(219) 844-9006

NPI assigned

Nov 25, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, KY, IN3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CG Medical Associates IncGroup PAC ID 6608052196, 171 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mayory.roberts@779530956636164.direct.elationemr.com
• Direct secure messaging: mayory.roberts.p1@direct.northshorehealth.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CG Medical Associates Inc

  • Urgent Care Clinic/Center
  • Cincinnati, OH
  • NPI 1982903951

  KY, Single Specialty

  Medicare reassignment Care Compare group NPD
• Lawrenceburg Urgent Care

  • Urgent Care Clinic/Center
  • Lawrenceburg, IN
  • NPI 1629181102

  Single Specialty

  Medicare reassignment NPD
• Northshore Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
  • NPI 1114257300

  Single Specialty

  Medicare reassignment NPD
• Complexcare Medical Group Midwest M PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1528851607

  OH, Single Specialty

  Medicare reassignment NPD
• Equitas Health,Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1518227453

  Single Specialty

  Medicare reassignment NPD
• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Chicago, IN
  • NPI 1336992999
  NPD
• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Portage, IN
  • NPI 1407061336

  Family

  NPD
• Equitas Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Toledo, OH
  • NPI 1063239911

  Single Specialty

  NPD
• Equitas Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Cincinnati, OH
  • NPI 1437799830

  Single Specialty

  NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  Single Specialty

  NPD

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1447896568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463689230",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 165TH ST STE A",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463202823",
            "telephone_number": "219-763-8112",
            "fax_number": "219-844-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MAYORY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "025912",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71010982A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren D. Richard, RN
• Karena Richardson
• RNC Management Indiana LLC
• Robert Prock MD LLC
• China Roberts
• Emily Lucille Robinson, PHARMD
• Ernestine Robinson
• Matteara Robinson
• Chisa Ann Roby, ASSOCIATE LICENSE
• Jean M Roche, CRNA

• Family Nurse Practitioner in Hammond, IN
• Providers in Hammond, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.