NPIMap

Individual provider Active NPI

Willis Reid Roberts Jr., M.D.

  • Internal Medicine Physician
  • Milledgeville, GA
National Provider Identifier
1689604449
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
045116 Issued in GA
Practice address
2803 N Columbia St Unit D
Milledgeville, GA 31061-6448
Phone
(478) 453-0662
NPI assigned
Jul 4, 2006
Last updated
Jul 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 045116 GA Primary

Addresses

Primary practice location

2803 N Columbia St Unit D
Milledgeville, GA 31061-6448

Mailing address

2803 N Columbia St Unit D
Milledgeville, GA 31061-6448
Phone (478) 453-0662

Other practice location 1

641 W Thomas St
Milledgeville, GA 31061-2337
Phone (478) 453-0662 ext. 228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308000620 GA Practitioner - Internal Medicine 7315129616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kentucky College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health Services of Central GeorgiaGroup PAC ID 9638076730, 300 clinicians

Practice addresses (Care Compare)

1120 Morningside Dr
Perry, GA 31069-2906
Phone (478) 987-3600

2803 N Columbia St
Unit D
Milledgeville, GA 31061-6448
Phone (478) 453-0662

821 N Cobb St
Milledgeville, GA 31061-2343
Phone (478) 776-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of Central Georgia, Inc CurrentSince Aug 1, 2017 Accepting new patients
John Wesley King, Jr. Current Accepting new patients
Catherine S. Roberts Internal Medicine Current Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients

Locations

770 Pine St
Ste 140
Macon, GA 31201
Phone (478) 633-1821

2803 N Columbia St
Unit D
Milledgeville, GA 31061
Phone (478) 414-5820

641 W Thomas St
Milledgeville, GA 31061
Phone (478) 452-6252

821 N Cobb St
Milledgeville, GA 31061
Phone (478) 454-3500

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

Interoperability endpoints

  • Direct secure messaging: reid.roberts@oconeeregional.gadirect.net
  • Direct secure messaging: wroberts433627@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1689604449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 N COLUMBIA ST UNIT D",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310616448",
            "telephone_number": "478-453-0662",
            "fax_number": "478-452-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 N COLUMBIA ST UNIT D",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310616448",
            "telephone_number": "478-453-0662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "641 W Thomas St",
            "address_purpose": "LOCATION",
            "city": "Milledgeville",
            "state": "GA",
            "postal_code": "310612337",
            "country_code": "US",
            "telephone_number": "478-453-0662 x228",
            "fax_number": "478-452-8067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "WILLIS",
        "middle_name": "REID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "045116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milledgeville, GA

Sources for this page

Verify at the official NPI Registry.