Individual provider Active NPI

Brian Miller Roberts, DO

  • Pediatrics Physician
  • Tuscaloosa, AL
National Provider Identifier
1457083362
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO4254 Issued in AL
Practice address
1060 Fairfax Park Ste C
Tuscaloosa, AL 35406-2837
Phone
(205) 752-7337
Fax
(205) 752-8013
NPI assigned
Jun 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO4254 AL Primary

Addresses

Primary practice location

1060 Fairfax Park Ste C
Tuscaloosa, AL 35406-2837

Mailing address

1060 Fairfax Park Ste C
Tuscaloosa, AL 35406-2837
Phone (205) 752-7337

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO4254ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce a Petitt M.D. P.C. Pediatrics PastSince Aug 10, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1457083362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 FAIRFAX PARK STE C",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062837",
            "telephone_number": "205-752-7337",
            "fax_number": "205-752-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 FAIRFAX PARK STE C",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062837",
            "telephone_number": "205-752-7337",
            "fax_number": "205-752-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRIAN",
        "middle_name": "MILLER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "DO4254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.