Active NPI
Shelia Y Roberts, ARNP
- Adult Health Nurse Practitioner
- Lake City, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- ARNP683592
- Practice address
- 289 SW Stonegate Ter
Suite 103
Lake City, FL 32024-3457 - Phone
- (386) 755-1655
- Fax
- (386) 755-2330
- NPI assigned
- Mar 6, 2006
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | ARNP683592 | FL | Primary |
Addresses
Primary practice location
289 SW Stonegate Ter
Suite 103
Lake City, FL 32024-3457
Mailing address
PO Box 1642
Lake City, FL 32056-1642
Phone (386) 755-1655
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTAN E6480V | Other | FL | LINKED TO GROUP PTAN IE881A EFFECTIVE 07/01/15 |
| 303991900 | Medicaid | FL | |
| K9539 | Other | FL | MEDICARE GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
289 SW Stonegate Ter
Suite 103
Lake City, FL 32024-3457
Phone (386) 755-1655
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake City Cancer Care LLC | Current | Accepting new patients | |
| Bruce I Timins MD PA | Past | Accepting new patients |
Locations
4520 W US Highway 90
Lake City, FL 32055
Phone (386) 755-0601
289 SW Stonegate Ter
Ste 103
Lake City, FL 32024
Phone (386) 755-1655
104 Woodmont Blvd
Ste 500
Nashville, TN 37205
Phone (615) 467-7400
Interoperability endpoints
- shelia.roberts@ccofnf.ikm.direct-ci.com
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.
-
- Hematology & Oncology Physician
- Lake City, FL
- NPI 1396132213
-
- Cardiovascular Disease Physician
- Lehigh Acres, FL
- NPI 1194993659
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lake City, FL
- NPI 1992751879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1750358073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1642",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320561642",
"telephone_number": "386-755-1655",
"fax_number": "386-755-2330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "289 SW STONEGATE TER",
"address_2": "SUITE 103",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320243457",
"telephone_number": "386-755-1655",
"fax_number": "386-755-2330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "SHELIA",
"middle_name": "Y",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-06",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "ARNP683592",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LINKED TO GROUP PTAN IE881A EFFECTIVE 07/01/15",
"identifier": "PTAN E6480V",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "303991900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "K9539",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lake City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.