Individual provider Active NPI

Kara Grace Roberts, CRNP

  • Pediatric Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1770840175
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1-109658 Issued in AL
Practice address
1600 7TH Ave S
Lowder 512
Birmingham, AL 35233-1711
Phone
(205) 638-5840
Fax
(205) 975-1941
NPI assigned
Apr 23, 2012
Last updated
Feb 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1-109658 AL Primary

Addresses

Primary practice location

1600 7TH Ave S
Lowder 512
Birmingham, AL 35233-1711

Mailing address

2846 Thornhill Rd Apt 51a
Mountain BRK, AL 35213-4040
Phone (205) 638-5840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1-109658ALMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1770840175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2846 THORNHILL RD APT 51A",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352134040",
            "telephone_number": "205-638-5840",
            "fax_number": "205-975-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "address_2": "LOWDER 512",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-638-5840",
            "fax_number": "205-975-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KARA",
        "middle_name": "GRACE",
        "name_prefix": "Miss",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-109658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; 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.