John William Roberts II

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN230702 Issued in GA

Practice address

901 18TH St E
Tifton, GA 31794-3648

Phone

(229) 382-7120

NPI assigned

Jan 3, 2018

Last updated

Jan 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, WY2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coffee Regional Medical Center IncGroup PAC ID 4587656012, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Coffee Regional Medical Center, Inc Hospital, Douglas, GA, CCN 110089

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.roberts.ii.1@8478.direct.athenahealth.com

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.

• Coffee Regional Medical Center, Inc

  • Anesthesiology Physician
  • Douglas, GA
  • NPI 1437120946

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Irwin County Anesthesia, Inc.

  • Certified Registered Nurse Anesthetist
  • Ocilla, GA
  • NPI 1275754103

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• Campbell County Hospital District

  dba Campbell County Medical Group - Internal Medicine Clinic

  • Internal Medicine Physician
  • Gillette, WY
  • NPI 1710098868
  Medicare reassignment NPD
• Coffee Regional Medical Center, Inc

  dba Coffee Regional First Care

  • Rural Health Clinic/Center
  • Douglas, GA
  • NPI 1639211956
  NPD
• Phoebe Senior Center

  • Clinic/Center
  • Camilla, GA
  • NPI 1821394271
  NPD
• Tift Regional Health System Inc

  dba Tift Regional Ophthalmology

  • Ophthalmology Physician
  • Tifton, GA
  • NPI 1790280857
  NPD
• Campbell County Hospital District

  dba Campbell County Medical Group-Anesthesiology

  • Anesthesiology Physician
  • Gillette, WY
  • NPI 1417461914
  NPD
• Campbell County Hospital District

  dba Behavioral Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gillette, WY
  • NPI 1881730141
  NPD
• Campbell County Hospital District

  dba Campbell County Health

  • Community/Retail Pharmacy
  • Gillette, WY
  • NPI 1992874218
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Coffee Regional Medical Center, Inc

  dba Coffee Regional Medical Center

  • General Acute Care Hospital
  • Douglas, GA
  • NPI 1760419527
  Care Compare affiliation

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1720595457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 HANSELL SEARS RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315355720",
            "telephone_number": "912-592-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "229-382-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-03",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "090060-23",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN230702",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN230702",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley D Ring, NP
• Megan Robbins, FNP-C
• Leanette S Roberson, MA LPC
• Robert a Hill DDS PC
• Boni-Lou Tamara Roberts, CADC II
• Justin Hugh Roberts, PA-C
• Kathy Lawson Roberts, SLP
• Marcus Carroll Roberts, M.D.
• Brent Jospeh Robison, CRNA
• Erin Nicole Robison

• Certified Registered Nurse Anesthetist in Tifton, GA
• Providers in Tifton, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.