Dalice Ballou Roberson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1419 Cumberland Falls Hwy
Corbin, KY 40701-2722

Phone

(606) 528-4481

NPI assigned

Dec 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grace Community Health Center, Inc.Group PAC ID 3870654064, 65 clinicians

H2 Rehabilitation Services of Kentucky, LLCGroup PAC ID 5799682688, shared by 7 NPIs, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Corbin Hospital, Corbin, KY, CCN 180080

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: droberson704232@direct.ochin.org

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.

• Grace Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Corbin, KY
  • NPI 1568625648
  Medicare reassignment Care Compare group NPD (past)
• Grace Community Health Center Inc

  dba Hyden Clinic

  • Federally Qualified Health Center (FQHC)
  • Hyden, KY
  • NPI 1598207557
  NPD
• Grace Community Health Center, Inc.

  dba Grace Health

  • Federally Qualified Health Center (FQHC)
  • Corbin, KY
  • NPI 1316645344
  NPD
• Chatuge Regional Hospital Inc

  dba Hayesville Family Practice

  • Rural Health Clinic/Center
  • Hayesville, NC
  • NPI 1093879744
  NPD (past)
• Chatuge Regional Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Hiawassee, GA
  • NPI 1982873212
  NPD (past)
• Wendy L Smith M.D. PC

  • Otolaryngology Physician
  • Blairsville, GA
  • NPI 1184880338
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Healthcare System, Inc

  dba Baptist Health Corbin

  • General Acute Care Hospital
  • Corbin, KY
  • NPI 1902865389
  Care Compare affiliation

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1508336389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 SCENIC VIEW HTS",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012188",
            "telephone_number": "606-261-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 CUMBERLAND FALLS HWY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012722",
            "telephone_number": "606-528-4481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2257 Highway 515 W Ste B",
            "address_purpose": "LOCATION",
            "city": "Blairsville",
            "state": "GA",
            "postal_code": "305123780",
            "country_code": "US",
            "telephone_number": "706-439-6860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1155 Main St",
            "address_purpose": "LOCATION",
            "city": "Young Harris",
            "state": "GA",
            "postal_code": "305824315",
            "country_code": "US",
            "telephone_number": "706-439-6873",
            "fax_number": "706-439-6874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Hwy 64 Business Ste 4",
            "address_purpose": "LOCATION",
            "city": "Hayesville",
            "state": "NC",
            "postal_code": "289049695",
            "country_code": "US",
            "telephone_number": "828-389-2273",
            "fax_number": "828-389-8291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 Hospital Way Ste A",
            "address_purpose": "LOCATION",
            "city": "Blairsville",
            "state": "GA",
            "postal_code": "305123144",
            "country_code": "US",
            "telephone_number": "706-745-4191",
            "fax_number": "706-745-9370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "DALICE",
        "middle_name": "BALLOU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Right Way Recovery LLC (Crosspoint Healing & Recovery)
• Jessica Alexandra Riley, APRN
• Kari Beth Roark Vergne, PA-C
• Cynthia Ann Roark
• Shelley Renee Robbins, BS
• Amber Ashley Roberts, LPCC
• Edith L Roberts, APRN
• Hannah Rea Lynn Roberts, BSW
• Jennings Asher Roberts, MSW
• Maleah Allise Roberts, BS

• Physician Assistant in Corbin, KY
• Providers in Corbin, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.