Individual provider Active NPI

Rebecca L Roberts, CNP,CDE

  • Adult Health Nurse Practitioner
  • Oakwood, OH
National Provider Identifier
1619123478
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
COA.10474-NP Issued in OH
Practice address
400 Sugar Camp Cir Ste 205
Oakwood, OH 45409-1981
Phone
(937) 395-3656
Fax
(937) 395-3657
NPI assigned
Aug 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X RN291690 OH
Registered Nurse 163W00000X 291690 OH
Adult Health Nurse Practitioner 363LA2200X COA.10474-NP OH Primary
Family Nurse Practitioner 363LF0000X NP-10474 OH

Addresses

Primary practice location

400 Sugar Camp Cir Ste 205
Oakwood, OH 45409-1981

Mailing address

400 Sugar Camp Cir Ste 205
Oakwood, OH 45409-1981
Phone (937) 395-3656

Other practice location 1

2649 Salem Ave Ste 510
Dayton, OH 45406-2932
Phone (937) 395-3656

Other practice location 2

136 S Ludlow St Fl 1
Dayton, OH 45402-1813
Phone (937) 499-8273

Other practice location 3

3130 N County Road 25A Ste 201
Troy, OH 45373-1337
Phone (937) 395-3656

Other identifiers 3

IdentifierTypeStateIssuer
000000599279OtherOHBCBS OHIO
2948341MedicaidOH
421534506138OtherOHCARESOURCE OHIO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090303000091 OH Practitioner - Nurse Practitioner 0547326316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians

Practice addresses (Care Compare)

2451 Wayne Ave
Dayton, OH 45420-1893
Phone (937) 252-1831

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
291690OHMDRegistered Nurse
RN291690OHMDDiabetes Educator Registered Nurse
COA.10474-NPOHMDAdult Health Nurse Practitioner
NP-10474OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc CurrentSince Jun 29, 2015 Accepting new patients
Mvhe Inc CurrentSince Jun 29, 2015 Accepting new patients
Mvhe Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

400 Sugar Camp Cir
Ste 205
Oakwood, OH 45409
Phone (937) 395-3656

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1619123478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SUGAR CAMP CIR STE 205",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454091981",
            "telephone_number": "937-395-3656",
            "fax_number": "937-395-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SUGAR CAMP CIR STE 205",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454091981",
            "telephone_number": "937-395-3656",
            "fax_number": "937-395-3657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2649 Salem Ave Ste 510",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454062932",
            "country_code": "US",
            "telephone_number": "937-395-3656",
            "fax_number": "937-395-3657",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "136 S Ludlow St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454021813",
            "country_code": "US",
            "telephone_number": "937-499-8273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 N County Road 25A Ste 201",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453731337",
            "country_code": "US",
            "telephone_number": "937-395-3656",
            "fax_number": "937-395-3657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "REBECCA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "CNP,CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "OH",
            "license": "RN291690",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "291690",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.10474-NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP-10474",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OHIO",
            "identifier": "000000599279",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2948341",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE OHIO",
            "identifier": "421534506138",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakwood, OH

Sources for this page

Verify at the official NPI Registry.