Gwendolyn Earle Roberson, MD, MA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

7770041-1205 Issued in UT

Practice address

1120 Route 73 Ste 300
Mount Laurel, NJ 08054-5113

Phone

(856) 930-4097

NPI assigned

Apr 13, 2009

Last updated

Jul 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT, NC, WI3 enrollments

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 3

Specialty

Psychiatry

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gwendolyn.robersonmd.p1@direct.cfg.nextgenshare.com

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.

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272

  Psychiatry

  Medicare reassignment NPD
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD
• The Monroe Clinic, Inc.

  dba SSM Health Monroe Clinic Medical Group

  • Specialist
  • Monroe, WI
  • NPI 1386720548
  Medicare reassignment NPD
• Yuma Regional Medical Center

  dba Onvida Health Yuma Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Care Compare group NPD
• Caromont Medical Group Inc

  dba CaroMont Psychiatric Associates

  • Psychiatry Physician
  • Gastonia, NC
  • NPI 1629197744
  NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD
• The Monroe Clinic, Inc.

  dba SSM Health Monroe Hospital

  • General Acute Care Hospital
  • Monroe, WI
  • NPI 1740291491
  NPD
• Yuma Regional Medical Center

  dba Onvida Health Yuma Medical Center

  • General Practice Physician
  • Yuma, AZ
  • NPI 1598993420
  NPD

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

• Yuma Regional Medical Center

  dba Onvida Health Yuma Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Care Compare affiliation

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1558504191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 S 1100 E",
            "address_2": "404",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 ROUTE 73 STE 300",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080545113",
            "telephone_number": "856-930-4097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Health Park Dr",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370274692",
            "country_code": "US",
            "telephone_number": "615-373-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "82 S 1100 E",
            "address_2": "404",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841021686",
            "country_code": "US",
            "telephone_number": "801-350-4777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2450 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541450",
            "country_code": "US",
            "telephone_number": "612-672-1163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7201 E 31st Pl",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853658394",
            "country_code": "US",
            "telephone_number": "928-336-5660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "GWENDOLYN",
        "middle_name": "EARLE",
        "credential": "MD, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "7770041-1205",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "74047",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "70664",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "7770041-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558504191",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Ringel
• Tara Ringer, RPH
• Rite Aid of New Jersey Inc (Rite Aid Pharmacy 01627)
• Azam H. Rizvi, M.D.
• RMX Monitoring LLC.
• Cherie Ann Roberts, LCSW
• Kayla Marie Roberts
• Moira Lynne Roberts
• Lena F Robinson, NURSE PRACTITIONER
• Nykia Iman Robinson, CNA

• Psychiatry Physician in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.