Individual provider Active NPI

Teresa Roberts, DNP, NNP-BC

  • Critical Care Neonatal Nurse Practitioner
  • Garden City, KS
National Provider Identifier
1629466545
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
53-80065-092 Issued in KS
Practice address
401 E Spruce St
Garden City, KS 67846-5679
Phone
(620) 722-2316
NPI assigned
Dec 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 81138 TN
Neonatal Intensive Care Registered Nurse 163WN0002X RN.413181 OH
Neonatal Nurse Practitioner 363LN0000X 53-80065-092 KS
Critical Care Neonatal Nurse Practitioner 363LN0005X C-APN.0002614-C-NP CO
Critical Care Neonatal Nurse Practitioner 363LN0005X APRN.CNP.17259 OH
Critical Care Neonatal Nurse Practitioner 363LN0005X 27571 TN
Critical Care Neonatal Nurse Practitioner 363LN0005X 53-80065-092 KS Primary

Addresses

Primary practice location

401 E Spruce St
Garden City, KS 67846-5679

Mailing address

420 Franklin Heights Dr
Winchester, TN 37398-4678
Phone (423) 677-1505

Other practice location 1

6001 E Woodmen Rd
Colorado Springs, CO 80923-2601
Phone (719) 571-8444

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

State licenses

LicenseStateTypeSpecialty
RN.413181OHMDNeonatal Intensive Care Registered Nurse
81138TNMDNeonatal Intensive Care Registered Nurse
C-APN.0002614-C-NPCOMDCritical Care Neonatal Nurse Practitioner
53-80065-092KSMDCritical Care Neonatal Nurse Practitioner
APRN.CNP.17259OHMDCritical Care Neonatal Nurse Practitioner
27571TNMDCritical Care Neonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1629466545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 FRANKLIN HEIGHTS DR",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373984678",
            "telephone_number": "423-677-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E SPRUCE ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465679",
            "telephone_number": "620-722-2316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6001 E Woodmen Rd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809232601",
            "country_code": "US",
            "telephone_number": "719-571-8444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "DNP, NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-30",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "TN",
            "license": "81138",
            "primary": false
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "OH",
            "license": "RN.413181",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "KS",
            "license": "53-80065-092",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CO",
            "license": "C-APN.0002614-C-NP",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "OH",
            "license": "APRN.CNP.17259",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "TN",
            "license": "27571",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "KS",
            "license": "53-80065-092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.