Individual provider Active NPI

Roberta Ann O'Brien, RN, CDOE

  • Diabetes Educator Registered Nurse
  • Lincoln, RI
National Provider Identifier
1619207461
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
RN22133 Issued in RI
Practice address
7 Jason Dr
Lincoln, RI 02865-4939
Phone
(401) 578-4560
Fax
(508) 819-4939
NPI assigned
Dec 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X RN22133 RI Primary

Addresses

Primary practice location

7 Jason Dr
Lincoln, RI 02865-4939

Mailing address

7 Jason Dr
Lincoln, RI 02865-4939
Phone (401) 578-4560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN22133RIMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1619207461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 JASON DR",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028654939",
            "telephone_number": "401-578-4560",
            "fax_number": "508-819-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 JASON DR",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028654939",
            "telephone_number": "401-578-4560",
            "fax_number": "508-819-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "ROBERTA",
        "middle_name": "ANN",
        "credential": "RN, CDOE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "RI",
            "license": "RN22133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.