Active NPI
Helmut Roberts
- Registered Nurse
- Indian Land, SC
National Provider Identifier
1679169692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R205376
- Practice address
- 2507 N Legacy Park Blvd
Indian Land, SC 29707-7772 - Phone
- (510) 207-5441
- NPI assigned
- Dec 14, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R205376 | SC | Primary |
Addresses
Primary practice location
2507 N Legacy Park Blvd
Indian Land, SC 29707-7772
Mailing address
2507 N Legacy Park Blvd
Indian Land, SC 29707-7772
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R205376 | Other | SC | BOARD OF NURSING |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R205376 | SC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607904000000",
"number": "1679169692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2507 N LEGACY PARK BLVD",
"city": "INDIAN LAND",
"state": "SC",
"postal_code": "297077772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2507 N LEGACY PARK BLVD",
"city": "INDIAN LAND",
"state": "SC",
"postal_code": "297077772",
"telephone_number": "510-207-5441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "HELMUT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-14",
"last_updated": "2020-12-14",
"certification_date": "2020-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "R205376",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF NURSING",
"identifier": "R205376",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indian Land, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.