Dr George T Roberts Optometrist PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV003200 Issued in NY

Legal business name

DR GEORGE T ROBERTS OPTOMETRIST PLLC

Practice address

75 Main St
Sidney, NY 13838-1138

Phone

(607) 563-7551

Fax

(607) 563-2442

NPI assigned

Dec 18, 2006

Organization subpart

No

Name

Mrs. Kathi J Roberts

Title

Practice Administrator

Phone

(607) 563-7551

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 5, 2012.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341446400000",
    "number": "1508929134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MAIN ST",
            "city": "SIDNEY",
            "state": "NY",
            "postal_code": "138381138",
            "telephone_number": "607-563-7551",
            "fax_number": "607-563-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MAIN ST",
            "city": "SIDNEY",
            "state": "NY",
            "postal_code": "138381138",
            "telephone_number": "607-563-7551",
            "fax_number": "607-563-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR GEORGE T ROBERTS OPTOMETRIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2012-07-05",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "KATHI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "607-563-7551",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02738127",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Anthony D'Souza, D.O.
• Mackenzie Jane Daly, DPT
• Laci Ahne Daniels, RN
• Davis and Nezelek Clinical Counseling
• Kenneth Edward Demott, FNP
• Dr. George T Roberts, Optometrist, PLLC
• Edward Nichols Edward Nichols Consulting
• Mark J. Edwards, D.C.
• Emergency Squad No 1 of Sidney Fire Dept of the Village of Sidney Inc
• Fairbanks Pharmacy Inc.

• All providers in Sidney, NY
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.