Organization Active NPI

Karen L. Roberts, D.O. Professional Corporation

  • Neuromusculoskeletal Medicine & OMM Physician
  • Portland, ME
National Provider Identifier
1760763155
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
1838 Issued in ME
Legal business name
KAREN L. ROBERTS, D.O. PROFESSIONAL CORPORATION
Practice address
535 Ocean Ave
Portland, ME 04103-4973
Phone
(207) 541-9285
Fax
(207) 773-7340
NPI assigned
Aug 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Authorized official

Name
Dr. Karen Lynne Roberts, D.O.NPI 1366467508
Title
Physician
Phone
(207) 541-9285

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 204D00000X 1838 ME Primary

Addresses

Primary practice location

535 Ocean Ave
Portland, ME 04103-4973

Mailing address

535 Ocean Ave
Portland, ME 04103-4973
Phone (207) 541-9285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120207000327 ME Part B Supplier - Clinic/Group Practice 8628235439 Receives reassigned benefits from 1 practitioner
Practice locations: Falmouth, ME

National Provider Directory

National Provider Directory

Locations

66 Leighton Rd
#1
Falmouth, ME 04105
Phone (207) 541-9285

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1760763155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 OCEAN AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034973",
            "telephone_number": "207-541-9285",
            "fax_number": "207-773-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 OCEAN AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034973",
            "telephone_number": "207-541-9285",
            "fax_number": "207-773-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN L. ROBERTS, D.O. PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-30",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "207-541-9285",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "1838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.