Active NPI
Jordin Roberts
- Mental Health Counselor
- Des Moines, IA
National Provider Identifier
1730737743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 097859
- Practice address
- 600 E Court Ave Ste 200
Des Moines, IA 50309-2058 - Phone
- (515) 243-3525
- NPI assigned
- Sep 3, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 097859 | IA | Primary |
Addresses
Primary practice location
600 E Court Ave Ste 200
Des Moines, IA 50309-2058
Mailing address
2631 Des Moines St
Des Moines, IA 50317-2352
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 097859 | IA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimae Lifeservices, Inc, | Past | Accepting new patients | |
| Optimae Rehabilitation Services LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Fairfield, IA
- NPI 1174520084
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Des Moines, IA
- NPI 1457912289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567468800000",
"number": "1730737743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2631 DES MOINES ST",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503172352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E COURT AVE STE 200",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503092058",
"telephone_number": "515-243-3525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JORDIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-03",
"last_updated": "2019-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "097859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.