NPIMap

Organization Active NPI

David F. Roberts, MD

  • Family Medicine Physician
  • Diamondhead, MS
National Provider Identifier
1770620403
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11771 Issued in MS
Legal business name
DAVID F. ROBERTS, MD
Practice address
5435 Gex Rd
Diamondhead, MS 39525-3208
Phone
(228) 255-4300
Fax
(228) 255-3626
NPI assigned
Jan 31, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Chele M Walley
Title
Billing Manager
Phone
(228) 255-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 11771 MS Primary

Addresses

Primary practice location

5435 Gex Rd
Diamondhead, MS 39525-3208

Mailing address

PO Box 6130
Diamondhead, MS 39525-6002
Phone (228) 255-4300

Other names 1

  • Diamondhead Family Medicine Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770620403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6130",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395256002",
            "telephone_number": "228-255-4300",
            "fax_number": "228-255-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5435 GEX RD",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253208",
            "telephone_number": "228-255-4300",
            "fax_number": "228-255-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID F. ROBERTS, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLEY",
        "authorized_official_first_name": "CHELE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "228-255-4300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "11771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diamondhead Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Diamondhead, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.