Alice J Roberts, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5004976 Issued in NC

Practice address

757 Bryant St
Statesville, NC 28677-4142

Phone

(704) 873-5658

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Tug River Health Association, Inc

  • Clinical Medical Laboratory
  • Gary, WV
  • NPI 1831275171
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1487743571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 TROY MILL RD",
            "city": "HAMPTONVILLE",
            "state": "NC",
            "postal_code": "270207265",
            "telephone_number": "704-539-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 BRYANT ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774142",
            "telephone_number": "704-873-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ALICE",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "0001132012",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001743447",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004033",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roger Lee Roark, MD
• Robert C. Tolle, D.D.S., P.a.
• Robert L Schmidt DMD PLLC
• Robert Scott Nance, DDS, Ms, PA
• Roberts DMD PLLC
• Linda Caroline Roberts, RN
• Steven Roberts, MSCCCSLP
• Rachel Robertson
• Gary T Robinson, MD
• Stephanie Lynn Robison, APRN-CNP

• Family Nurse Practitioner in Statesville, NC
• Providers in Statesville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.