Individual provider Active NPI

Sherry Lynn Roberts, FNP

  • Family Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1467069666
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1008208 Issued in TX
Practice address
3002 Moores LN
Texarkana, TX 75503-2204
Phone
(430) 200-4350
NPI assigned
Sep 30, 2020
Last updated
Dec 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1008208 TX Primary

Addresses

Primary practice location

3002 Moores LN
Texarkana, TX 75503-2204

Mailing address

342 Katima LN
Bullard, TX 75757-2987
Phone (936) 645-7071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210907000061 TX Practitioner - Nurse Practitioner 6800292533 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Compliance & Screening Services CSS PastSince Sep 1, 2021 Accepting new patients
Arnot Medical Services PLLC Past Accepting new patients
CSS Healthcare, LLC PastSince Oct 1, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16477/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1467069666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 KATIMA LN",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757572987",
            "telephone_number": "936-645-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032204",
            "telephone_number": "430-200-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SHERRY",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2021-12-17",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1008208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.