Individual provider Active NPI

Cynthia Roberts, RN

  • Diabetes Educator Registered Nurse
  • College Station, TX
National Provider Identifier
1700207016
Registry record updated Jan 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
741695 Issued in TX
Practice address
713 Dover Dr
College Station, TX 77845-7905
Phone
(979) 204-9614
Fax
(979) 764-5124
NPI assigned
Jan 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 741695 TX Primary

Addresses

Primary practice location

713 Dover Dr
College Station, TX 77845-7905

Mailing address

713 Dover Dr
College Station, TX 77845-7905
Phone (979) 204-9614

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)
Enrolled
Credentials
Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1388793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388793600000",
    "number": "1700207016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 DOVER DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778457905",
            "telephone_number": "979-204-9614",
            "fax_number": "979-764-5124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 DOVER DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778457905",
            "telephone_number": "979-204-9614",
            "fax_number": "979-764-5124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CYNTHIA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-04",
        "last_updated": "2014-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "TX",
            "license": "741695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2014; 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.