Individual provider Active NPI

Kayleen Roberts

  • Social Worker
  • Wayne, NE
National Provider Identifier
1689480071
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
99202397 Issued in NE
Practice address
709 W 1St St
Wayne, NE 68787-1616
Phone
(402) 369-3574
NPI assigned
Dec 10, 2024
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 99202397 NE Primary

Addresses

Primary practice location

709 W 1St St
Wayne, NE 68787-1616

Mailing address

405 Main St
Carroll, NE 68723-8012
Phone (402) 369-3574

Other practice location 1

405 Main St
Carroll, NE 68723-8012
Phone (402) 369-3574

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
99202397NEMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1689480071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MAIN ST",
            "city": "CARROLL",
            "state": "NE",
            "postal_code": "687238012",
            "telephone_number": "402-369-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 W 1ST ST",
            "city": "WAYNE",
            "state": "NE",
            "postal_code": "687871616",
            "telephone_number": "402-369-3574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Main St",
            "address_purpose": "LOCATION",
            "city": "Carroll",
            "state": "NE",
            "postal_code": "687238012",
            "country_code": "US",
            "telephone_number": "402-369-3574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KAYLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NE",
            "license": "99202397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.