Jerry Thomas Roberts, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

00439 Issued in KY

Practice address

117 Tradepark Dr
Somerset, KY 42503-3428

Phone

(606) 679-2773

Fax

(606) 679-4626

NPI assigned

May 3, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upperline Healthcare PCGroup PAC ID 4385900653, 194 clinicians

Vital Path Care PCGroup PAC ID 8022532613, 52 clinicians

360Care Services of Kentucky LLCGroup PAC ID 9931587888, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lake Cumberland Regional Hospital Hospital, Somerset, KY, CCN 180132

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: roberts.jerry.011.0170067@cfa.meditab.direct-ci.com
• Direct secure messaging: roberts.jerry.006.0170067@cfa.meditab.direct-ci.com
• Direct secure messaging: jerry.roberts.1@4399.direct.athenahealth.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: roberts.jerry.007.0170067@cfa.meditab.direct-ci.com
• Direct secure messaging: roberts.jerry.012.0170067@cfa.meditab.direct-ci.com

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.

• 360Care Services of Kentucky LLC

  • Social Worker
  • Louisville, KY
  • NPI 1669113023
  Medicare reassignment Care Compare group NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  KY

  Medicare reassignment Care Compare group NPD
• Vital Path Care PC

  • Podiatrist
  • Hoover, AL
  • NPI 1619788858

  Foot & Ankle Surgery, KY

  Medicare reassignment Care Compare group NPD
• Cumberland Foot & Ankle Centers

  • Foot & Ankle Surgery Podiatrist
  • Somerset, KY
  • NPI 1093901100
  Medicare reassignment NPD
• 360Care Services of Kentucky LLC

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1174394852
  NPD
• Cumberland Foot and Ankle Centers

  • Foot & Ankle Surgery Podiatrist
  • Franklin, KY
  • NPI 1912512724
  NPD
• Mark J Henson DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Griffin, GA
  • NPI 1649452632
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• 360Care Services of Kentucky LLC

  • Podiatrist
  • Louisville, KY
  • NPI 1477324150
  NPD (past)

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

• Lake Cumberland Regional Hospital LLC

  • Rural Acute Care Hospital
  • Somerset, KY
  • NPI 1619038247
  Care Compare affiliation

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1629395405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 TRADEPARK DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033428",
            "telephone_number": "606-679-2773",
            "fax_number": "606-679-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 TRADEPARK DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033428",
            "telephone_number": "606-679-2773",
            "fax_number": "606-679-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JERRY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-03",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001206",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "00439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Rizkalla, DPM
• Robert Moore Hearing Aid Center, Dba Beltone
• Robert R. Cunningham, M.D., OB-GYN, P.L.L.C.
• Brad Roberts, OTR/L
• Jason G Roberts
• Megan D Roberts
• Shelby Roberts, CSW
• Tiffany Roberts, LPCC
• Kaegan Robertson
• Cody Randall Robinette

• Foot & Ankle Surgery Podiatrist in Somerset, KY
• Providers in Somerset, KY by specialty
• Foot & Ankle Surgery Podiatrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.