Individual provider Active NPI

Tonya C Roberts, APRN

  • Family Nurse Practitioner
  • Signal Mountain, TN
National Provider Identifier
1689000747
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22768 Issued in TN
Practice address
796 Ridgeway Ave
Signal Mountain, TN 37377-3067
Phone
(423) 886-3269
NPI assigned
Sep 20, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A003921 AR
Family Nurse Practitioner 363LF0000X 22768 TN Primary

Addresses

Primary practice location

796 Ridgeway Ave
Signal Mountain, TN 37377-3067

Mailing address

796 Ridgeway Ave
Signal Mountain, TN 37377-3067
Phone (423) 886-3269

Other practice location 1

405 Highway 11 N
Des Arc, AR 72040-3140
Phone (870) 256-4179

Other identifiers 1

IdentifierTypeStateIssuer
199165758MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A003921ARMDFamily Nurse Practitioner
22768TNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689000747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "796 RIDGEWAY AVE",
            "city": "SIGNAL MOUNTAIN",
            "state": "TN",
            "postal_code": "373773067",
            "telephone_number": "423-886-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "796 RIDGEWAY AVE",
            "city": "SIGNAL MOUNTAIN",
            "state": "TN",
            "postal_code": "373773067",
            "telephone_number": "423-886-3269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Highway 11 N",
            "address_purpose": "LOCATION",
            "city": "Des Arc",
            "state": "AR",
            "postal_code": "720403140",
            "country_code": "US",
            "telephone_number": "870-256-4179",
            "fax_number": "870-256-4085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TONYA",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A003921",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199165758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Signal Mountain, TN

Sources for this page

Verify at the official NPI Registry.