Alfred Roy Roberts, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1201-3 Issued in KS

Practice address

8150 E Douglas Ave
Suite 50
Wichita, KS 67206-2376

Phone

(316) 942-7496

Fax

(316) 239-2557

NPI assigned

Nov 16, 2006

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 names 1

• A Roy Roberts Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1568535656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 W DOUGLAS AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672132605",
            "telephone_number": "316-942-7496",
            "fax_number": "316-239-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 E DOUGLAS AVE",
            "address_2": "SUITE 50",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062376",
            "telephone_number": "316-942-7496",
            "fax_number": "316-239-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ALFRED",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1201-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "A",
            "last_name": "ROBERTS",
            "middle_name": "ROY",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Audrey M Roberts, MD
• Danielle L Roberts, LMFT
• Derek L Roberts, APRN-BC
• Gregory Dalton Roberts

• Optometrist in Wichita, KS
• Providers in Wichita, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.