Individual provider Active NPI

Duana J Roberts, NP

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1528439783
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP129210 Issued in TX
Practice address
3310 Patriot Dr
Tyler, TX 75701-6606
Phone
(903) 939-7870
NPI assigned
Oct 14, 2015
Last updated
Oct 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP129210 TX Primary

Addresses

Primary practice location

3310 Patriot Dr
Tyler, TX 75701-6606

Mailing address

PO Box 731912
Dallas, TX 75373-1912
Phone (903) 939-7870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20151117001685 TX Practitioner - Nurse Practitioner 9638489990 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Oct 19, 2015 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Oct 19, 2015 Accepting new patients

Locations

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

3310 Patriot Dr
Tyler, TX 75701
Phone (903) 877-8925

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1528439783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731912",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731912",
            "telephone_number": "903-939-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 PATRIOT DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757016606",
            "telephone_number": "903-939-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DUANA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP129210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.