Individual provider Active NPI

John R. Roberts, D.O.

  • Family Medicine Physician
  • Columbia, TN
National Provider Identifier
1740635440
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3380 Issued in TN
Practice address
854 W James M Campbell Blvd Ste 403
Columbia, TN 38401-4659
Phone
(931) 380-0075
Fax
(931) 388-7502
NPI assigned
Apr 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3380 TN Primary

Addresses

Primary practice location

854 W James M Campbell Blvd Ste 403
Columbia, TN 38401-4659

Mailing address

854 W James M Campbell Blvd Ste 303
Columbia, TN 38401-4672
Phone (931) 380-0075

Other practice location 1

1020 N Highland Ave
Suite C
Murfreesboro, TN 37130-2494
Phone (615) 396-6454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190807002788 TN Practitioner - Family Practice 0042500761 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3380TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Maury Regional Hospital CurrentSince Nov 1, 2021 Accepting new patients
Maury Regional Hospital CurrentSince Nov 1, 2021 Accepting new patients
Maury Regional Medical Group, Inc Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Maury Regional Hospital Marshall Medical Center CurrentSince Aug 1, 2019 Accepting new patients
Maury Regional Hospital Current Accepting new patients
Maury Regional Hospital Current Accepting new patients
Global Physician Network LLC Series II PastSince Jan 29, 2023 Accepting new patients

Locations

854 W James M Campbell Blvd
Ste 301
Columbia, TN 38401
Phone (931) 388-8779

854 W James M Campbell Blvd
Ste 303
Columbia, TN 38401
Phone (931) 388-8779

854 W James M Campbell Blvd
Ste 403
Columbia, TN 38401
Phone (931) 380-0075

1114 W 7th St
Columbia, TN 38401
Phone (931) 388-9706

617 W Main St
Hohenwald, TN 38462
Phone (931) 796-4901

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1461974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1740635440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 W JAMES M CAMPBELL BLVD STE 303",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014672",
            "telephone_number": "931-380-0075",
            "fax_number": "931-388-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 W JAMES M CAMPBELL BLVD STE 403",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014659",
            "telephone_number": "931-380-0075",
            "fax_number": "931-388-7502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 N Highland Ave",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371302494",
            "country_code": "US",
            "telephone_number": "615-396-6454",
            "fax_number": "615-396-6635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JOHN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-30",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "3380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.