NPIMap

Individual provider Active NPI

Gary Frank Roberts, DO

  • Cardiovascular Disease Physician
  • Prestonsburg, KY
National Provider Identifier
1689636599
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
TP824 Issued in KY
Practice address
1279 Old Abbott Mountain Rd
Prestonsburg, KY 41653-1889
Phone
(606) 886-0892
Fax
(606) 886-9746
NPI assigned
Apr 5, 2006
Last updated
Dec 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X TP824 KY Primary
Cardiovascular Disease Physician 207RC0000X 1374 WV

Addresses

Primary practice location

1279 Old Abbott Mountain Rd
Prestonsburg, KY 41653-1889

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-9565

Other identifiers 1

IdentifierTypeStateIssuer
0045175000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200115002905 KY Practitioner - Cardiovascular Disease (Cardiology) 4880670850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
West Virginia School of Osteopathic Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1279 Old Abbott Mountain Rd
Prestonsburg, KY 41653-1889
Phone (606) 886-1260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.04 of 100Reported as group
Quality
60.55
Promoting interoperability
100
Improvement activities
40
Cost
78.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1374WVMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc CurrentSince Jan 1, 2020 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Jan 1, 2020 Accepting new patients
Greenbrier VMC LLC Cardiovascular Disease Past Accepting new patients
Greenbrier VMC LLC Cardiovascular Disease Past Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Kings Daughters Medical Specialties Inc Cardiovascular Disease Past Accepting new patients
Greenbrier Physicians, Inc Past Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

354 N Mayo Trl
Paintsville, KY 41240
Phone (606) 372-0221

Interoperability endpoints

  • Direct secure messaging: groberts71741@direct.kdhealth.us

Organizations & group practices 7

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 6

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1689636599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-9565",
            "fax_number": "606-408-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 OLD ABBOTT MOUNTAIN RD",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531889",
            "telephone_number": "606-886-0892",
            "fax_number": "606-886-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "GARY",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "TP824",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WV",
            "license": "1374",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0045175000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prestonsburg, KY

Sources for this page

Verify at the official NPI Registry.