Kristy M Roberts, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E4288 Issued in AR

Practice address

3025 Fountain Dr
Suite 100
Conway, AR 72034-3684

Phone

(501) 932-5060

Fax

(501) 552-5330

NPI assigned

Feb 1, 2006

Last updated

Dec 14, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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 1

Specialty

Family Practice

Education

Oklahoma State University College of Osteopathic Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Conway Regional Medical Center IncGroup PAC ID 3173428414, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Conway Regional Medical Center Inc

  dba Conway Medical Group

  • Family Medicine Physician
  • Conway, AR
  • NPI 1841200417
  Medicare reassignment Care Compare group NPD
• Conway Regional Medical Center Inc

  dba Conway Regional Mobile Health Unit

  • Family Medicine Physician
  • Conway, AR
  • NPI 1043183544
  NPD
• Conway Regional Medical Center, Inc.

  dba Conway Regional Medical Clinic-Prince St.

  • Family Medicine Physician
  • Conway, AR
  • NPI 1275990871
  NPD

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

• Conway Regional Medical Center Inc

  dba Conway Regional Medical Clinic-Vilonia

  • Rural Health Clinic/Center
  • Vilonia, AR
  • NPI 1063798858

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center Inc

  • General Acute Care Hospital
  • Conway, AR
  • NPI 1497770424
  Care Compare affiliation
• Conway Regional Medical Center Inc

  • Clinical Medical Laboratory
  • Conway, AR
  • NPI 1609123017

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc

  dba Conway Regional Medical Clinic-Russellville

  • Family Medicine Physician
  • Russellville, AR
  • NPI 1245729359

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc

  dba Conway Regional Counseling Center

  • Psychiatry Physician
  • Conway, AR
  • NPI 1730402249

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc.

  dba Mayflower Medical Clinic

  • Rural Health Clinic/Center
  • Mayflower, AR
  • NPI 1851389605

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1578534012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 FOUNTAIN DR",
            "address_2": "SUITE 100",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343684",
            "telephone_number": "501-932-5060",
            "fax_number": "501-552-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 FOUNTAIN DR",
            "address_2": "SUITE 100",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343684",
            "telephone_number": "501-932-5060",
            "fax_number": "501-552-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KRISTY",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E4288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158728003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Roberson, RD
• Bethany Roberts, CRNA
• Cynthia Marie Roberts, PT
• Haley Ranae Roberts
• Joshua Roberts, PHARMD
• Taylor Beth Roberts
• Tessa Roberts, ST
• Thomas S Roberts, M.D.
• Donna Robertson, LPE
• Heather Robertson

• Family Medicine Physician in Conway, AR
• Providers in Conway, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; 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.