Active NPI
Michael Elvin Roberts, ATC
- Athletic Trainer
- Omaha, NE
National Provider Identifier
1528047156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 316
- Practice address
- 2725 S 144TH St
Ste 212
Omaha, NE 68144-5243 - Phone
- (402) 637-0668
- Fax
- (402) 637-0808
- NPI assigned
- Jan 12, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 316 | NE | Primary |
Addresses
Primary practice location
2725 S 144TH St
Ste 212
Omaha, NE 68144-5243
Mailing address
2725 S 144TH St
Ste 212
Omaha, NE 68144-5243
Phone (402) 637-0668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 316 | NE | MD | Foot Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459296000000",
"number": "1528047156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 S 144TH ST",
"address_2": "STE 212",
"city": "OMAHA",
"state": "NE",
"postal_code": "681445243",
"telephone_number": "402-637-0668",
"fax_number": "402-637-0808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2725 S 144TH ST",
"address_2": "STE 212",
"city": "OMAHA",
"state": "NE",
"postal_code": "681445243",
"telephone_number": "402-637-0668",
"fax_number": "402-637-0808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "MICHAEL",
"middle_name": "ELVIN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-12",
"last_updated": "2016-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.