Individual provider Active NPI

Laurie Roberts, ARNP

  • Family Nurse Practitioner
  • Powderly, KY
National Provider Identifier
1730286360
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3002916 Issued in KY
Practice address
1010 Medical Center Dr
Powderly, KY 42367-5463
Phone
(270) 377-1600
Fax
(270) 326-4968
NPI assigned
Sep 17, 2006
Last updated
Mar 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3002916 KY Primary

Addresses

Primary practice location

1010 Medical Center Dr
Powderly, KY 42367-5463

Mailing address

900 Hospital Dr
Madisonville, KY 42431-1644
Phone (270) 825-7200

Other identifiers 4

IdentifierTypeStateIssuer
2916POtherKYLICENSE
P01099331OtherKYRR MEDICARE- POWDERLY
78029162MedicaidKY
000000186602OtherBCBS PROVIDER NUMBER

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: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2017 through Jan 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3002916KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Neurology LLC Current Accepting new patients
Baptist Health Deaconess Madisonville Inc Past Accepting new patients
Baptist Health Madisonville Inc Past Accepting new patients

Locations

200 Clinic Dr
Madisonville, KY 42431
Phone (270) 821-8874

Organizations & group practices 3

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1730286360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HOSPITAL DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311644",
            "telephone_number": "270-825-7200",
            "fax_number": "270-326-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MEDICAL CENTER DR",
            "city": "POWDERLY",
            "state": "KY",
            "postal_code": "423675463",
            "telephone_number": "270-377-1600",
            "fax_number": "270-326-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LAURIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3002916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2916P",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE- POWDERLY",
            "identifier": "P01099331",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78029162",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "000000186602",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powderly, KY

Sources for this page

Verify at the official NPI Registry.