Individual provider Active NPI

Diana Roberson

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1689875965
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2010-00995 Issued in NC
Practice address
231 S Sharon Amity Rd
Charlotte, NC 28211-2803
Phone
(704) 304-6400
NPI assigned
May 31, 2007
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2010-00995 NC Primary

Addresses

Primary practice location

231 S Sharon Amity Rd
Charlotte, NC 28211-2803

Mailing address

231 S Sharon Amity Rd
Charlotte, NC 28211-2803

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Nov 28, 2017 through Nov 28, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010-00995NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatrics Pediatrics PastSince Nov 24, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1689875965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 S SHARON AMITY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 S SHARON AMITY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112803",
            "telephone_number": "704-304-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "DIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2010-00995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.