NPIMap

Organization Active NPI

Clifford William Roberson Jr.

  • Orthopaedic Surgery Physician
  • Point Pleasant, WV
National Provider Identifier
1659740066
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
22760 Issued in WV
Legal business name
CLIFFORD WILLIAM ROBERSON JR.
Practice address
3009 Jackson Ave
Point Pleasant, WV 25550-1717
Phone
(304) 675-8095
Fax
(304) 675-8096
NPI assigned
Sep 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Authorized official

Name
Dr. Clifford William Roberson Jr., MD
Title
Owner
Phone
(304) 812-4182

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 22760 WV Primary
Clinic/Center 261Q00000X 22760 WV

Addresses

Primary practice location

3009 Jackson Ave
Point Pleasant, WV 25550-1717

Mailing address

3009 Jackson Ave
Point Pleasant, WV 25550-1717
Phone (304) 675-8095

Other identifiers 4

IdentifierTypeStateIssuer
0143290MedicaidOH
3810009163MedicaidWV
2765459MedicaidOH
3910007237MedicaidWV

Other names 1

  • ROBERSON ORTHOPEDIC CLINIC Other name

National Provider Directory

National Provider Directory

Locations

3009 Jackson Ave
Pt Pleasant, WV 25550
Phone (304) 675-1637

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1659740066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 JACKSON AVE",
            "city": "POINT PLEASANT",
            "state": "WV",
            "postal_code": "255501717",
            "telephone_number": "304-675-8095",
            "fax_number": "304-675-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 JACKSON AVE",
            "city": "POINT PLEASANT",
            "state": "WV",
            "postal_code": "255501717",
            "telephone_number": "304-675-8095",
            "fax_number": "304-675-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFFORD WILLIAM ROBERSON JR.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-812-4182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "WV",
            "license": "22760",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WV",
            "license": "22760",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0143290",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009163",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2765459",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3910007237",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROBERSON ORTHOPEDIC CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Point Pleasant, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.