Glenn A Roberts, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO314 Issued in AL

Practice address

Cherry Hospital
1401 West Ash Street
Goldsboro, NC 27530-1078

Phone

(919) 731-3206

Fax

(919) 731-3785

NPI assigned

Nov 21, 2005

Last updated

Oct 6, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Healthcare Authority of Elba, Alabama

  dba Elba Nursing Home

  • Skilled Nursing Facility
  • Elba, AL
  • NPI 1013902576
  NPD (past)

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1508849852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHERRY HOSPITAL",
            "address_2": "1401 WEST ASH STREET",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275301078",
            "telephone_number": "919-731-3206",
            "fax_number": "919-731-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHERRY HOSPITAL",
            "address_2": "1401 WEST ASH STREET",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275301078",
            "telephone_number": "919-731-3206",
            "fax_number": "919-731-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "GLENN",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009937180",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baraka Riptoe
• Pamella R Ritt, SPEECH PATHOLOGIST
• Emilie Rivera
• Ryan L Robbins, DMD
• Celia Roberts, FNP-BC
• Jasmine Andrea Roberts
• Jasmine Moon Roberts, M.D.
• Johnnie Ray Roberts
• Forrest Cody Robinson, LCAS-A
• Wyanet Robinson

• Family Medicine Physician in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.