Trevor Roberts

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

1645 Hewitt Drive
Virginia Beach,, VA 23460

Phone

(757) 462-3991

NPI assigned

Mar 27, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• United States Navy

  • Military Hospital
  • San Diego, CA
  • NPI 1003226309
  NPD (past)

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

{
    "created_epoch": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1770160459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7571 RADENZ AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 HEWITT DRIVE",
            "city": "VIRGINIA BEACH,",
            "state": "VA",
            "postal_code": "23460",
            "telephone_number": "757-462-3991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34101 Farenholt Ave Bldg 14",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921347000",
            "country_code": "US",
            "telephone_number": "619-532-7968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TREVOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-27",
        "last_updated": "2023-06-08",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Marie Roberts, MS, CCC-SLP
• Sara Beth Roberts, DOULA
• Shanell Nicole Roberts
• Stephanie Ricard Roberts, P.T.
• Susan A Roberts
• Courtney Brooke Robertson, PA-C
• Heather Yanni Robertson, M.A., CCC-SLP
• Jacqueline Ann Robertson
• Jenna-Paix Robertson, CLC
• Shawna Robertson, LMT

• Independent Duty Corpsman in Virginia Beach,, VA
• Providers in Virginia Beach,, VA by specialty
• Independent Duty Corpsman in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.