Active NPI
James M Roberts, OTR/L, OTD
- Occupational Therapist
- Anacortes, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT61311258
- Practice address
- 1017 20TH St
Anacortes, WA 98221-2505 - Phone
- (360) 424-7041
- Fax
- (360) 424-2456
- NPI assigned
- Aug 19, 2020
- Last updated
- Apr 2, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT61311258 | WA | Primary |
| Hand Occupational Therapist | 225XH1200X | OT61311258 | WA |
Addresses
Primary practice location
1017 20TH St
Anacortes, WA 98221-2505
Mailing address
1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone (360) 424-7041
Other practice location 1
1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone (360) 424-7041
Other names 1
- Jimmy M Roberts
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1017 20TH St
Anacortes, WA 98221-2505
Phone (360) 424-7041
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT61311258 | WA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proliance Surgeons Inc P S | Current | Accepting new patients | |
| Proliance Surgeons Inc P S | Current | Accepting new patients | |
| Proliance Surgeons Inc P S | Current | Accepting new patients |
Locations
1017 20th St
Anacortes, WA 98221
Phone (360) 424-7041
1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400
805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100
Organizations & group practices 3
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.
-
dba Proliance Surgeons Orthopedic Specialists of Seattle
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1023170313
-
dba Proliance Orthopedic Associates
- Orthopaedic Surgery Physician
- Renton, WA
- NPI 1235091463
-
dba Proliance Pacific Rim Orthopedic Surgeons
- Multi-Specialty Clinic/Center
- Bellingham, WA
- NPI 1801497995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1487266508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 S LAVENTURE RD",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982746033",
"telephone_number": "360-424-7041",
"fax_number": "360-424-2456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 20TH ST",
"city": "ANACORTES",
"state": "WA",
"postal_code": "982212505",
"telephone_number": "360-424-7041",
"fax_number": "360-424-2456"
}
],
"practiceLocations": [
{
"address_1": "1401 S Laventure Rd",
"address_purpose": "LOCATION",
"city": "Mount Vernon",
"state": "WA",
"postal_code": "982746033",
"country_code": "US",
"telephone_number": "360-424-7041",
"fax_number": "360-424-2456",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTS",
"first_name": "JAMES",
"middle_name": "M",
"credential": "OTR/L, OTD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-19",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT61311258",
"primary": true
},
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "WA",
"license": "OT61311258",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JIMMY",
"last_name": "ROBERTS",
"middle_name": "M",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Anacortes, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.