Active NPI
James J Roberts, OD
- Optometrist
- Estherville, IA
National Provider Identifier
1700870037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1507
- Practice address
- 709 1St Ave S
Box 437
Estherville, IA 51334-2352 - Phone
- (712) 362-5822
- Fax
- (712) 362-4213
- NPI assigned
- Sep 1, 2005
- Last updated
- Mar 6, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1507 | IA | Primary |
Addresses
Primary practice location
709 1St Ave S
Box 437
Estherville, IA 51334-2352
Mailing address
709 1St Ave S
Box 437
Estherville, IA 51334-2352
Phone (712) 362-5822
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0663440001 | Other | DURABLE MED | |
| 0082651 | Medicaid | IA | |
| 200857740A | Medicaid | IN | |
| 214L1R0 | Other | BC OF MN | |
| 42137593300 | Medicaid | NE | |
| 9201620 | Medicaid | SD | |
| 464223600 | Medicaid | MN | |
| 86635R0 | Other | BC OF MN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1507 | IA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394064000000",
"number": "1700870037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 1ST AVE S",
"address_2": "BOX 437",
"city": "ESTHERVILLE",
"state": "IA",
"postal_code": "513342352",
"telephone_number": "712-362-5822",
"fax_number": "712-362-4213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 1ST AVE S",
"address_2": "BOX 437",
"city": "ESTHERVILLE",
"state": "IA",
"postal_code": "513342352",
"telephone_number": "712-362-5822",
"fax_number": "712-362-4213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JAMES",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-01",
"last_updated": "2014-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IA",
"license": "1507",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DURABLE MED",
"identifier": "0663440001",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0082651",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200857740A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC OF MN",
"identifier": "214L1R0",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42137593300",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9201620",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "464223600",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC OF MN",
"identifier": "86635R0",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Estherville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.