Mindy Roberts, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

215776 Issued in SC

Practice address

923 Currytowne Blvd
North Augusta, SC 29860-8929

Phone

(803) 508-0125

NPI assigned

Apr 2, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1710739016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 GEORGIA AVE SUITE 106",
            "address_2": "BOX #176",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "29841",
            "telephone_number": "803-508-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 CURRYTOWNE BLVD",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298608929",
            "telephone_number": "803-508-0125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2050 Walton Way",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309042305",
            "country_code": "US",
            "telephone_number": "706-434-1590",
            "fax_number": "706-434-1595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MINDY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-02",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "215776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in North Augusta, SC
• Providers in North Augusta, SC by specialty
• Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.