Mark A Roberts, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

020863 Issued in SC

Practice address

415 Barnwell Ave NW
Aiken, SC 29801

Phone

(803) 644-4403

Fax

(803) 644-4405

NPI assigned

Oct 27, 2006

Last updated

Jan 30, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517270400000",
    "number": "1679659213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BARNWELL AVE NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "29801",
            "telephone_number": "803-644-4403",
            "fax_number": "803-644-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BARNWELL AVE NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "29801",
            "telephone_number": "803-644-4403",
            "fax_number": "803-644-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2018-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "020863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T38368",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED BD LLR",
            "identifier": "020863",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Rittenhouse
• Carly Ritter, PT, DPT, OCS
• Riverside Ambulance Service, LLC
• Robert L Buchanan III DMD
• Lori Rene Roberts, O D
• Robinson Group Holdings, Inc. (Seniors Helping Seniors Aiken)
• Akaycha Vertis Robinson
• Harold Amos Robinson III
• Krystal Robinson
• Malinda E. Robinson, DC

• Family Medicine Physician in Aiken, SC
• Providers in Aiken, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; 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.