NPIMap

Individual provider Active NPI

Kylee Ann Roberts, M.D.

  • Family Medicine Physician
  • Groveton, NH
National Provider Identifier
1770844144
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20636 Issued in NH
Practice address
47 Church St
Groveton, NH 03582-4061
Phone
(603) 636-1101
NPI assigned
Jun 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20636 NH Primary
Family Medicine Physician 207Q00000X 17946 NV

Addresses

Primary practice location

47 Church St
Groveton, NH 03582-4061

Mailing address

47 Church St
Groveton, NH 03582-4061
Phone (603) 636-1101

Other identifiers 2

IdentifierTypeStateIssuer
1770844144MedicaidNV
14240674OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826003978 NH Practitioner - Family Practice 5597070888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nevada School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weeks Medical CenterGroup PAC ID 2769461284, 71 clinicians

Practice addresses (Care Compare)

141 Corliss LN
Colebrook, NH 03576-3206
Phone (603) 237-5899

173 Middle St
Lancaster, NH 03584-3508
Phone (603) 788-4911

47 Church St
Groveton, NH 03582-4061
Phone (603) 636-1101

6 Duranleau St
West Stewartstown, NH 03597-4403
Phone (603) 246-3400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
127929CAMDClinical Social Worker
17946NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weeks Medical Center Current Accepting new patients
Weeks Medical Center CurrentSince Feb 8, 2023 Accepting new patients
Weeks Medical Center CurrentSince Feb 8, 2023 Accepting new patients
Androscoggin Valley Hospital Inc Family Medicine Past Accepting new patients

Locations

141 Corliss Ln
Colebrook, NH 03576
Phone (603) 237-5899

47 Church St
Groveton, NH 03582
Phone (603) 636-1101

173 Middle St
Lancaster, NH 03584
Phone (603) 788-4911

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1770844144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CHURCH ST",
            "city": "GROVETON",
            "state": "NH",
            "postal_code": "035824061",
            "telephone_number": "603-636-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 CHURCH ST",
            "city": "GROVETON",
            "state": "NH",
            "postal_code": "035824061",
            "telephone_number": "603-636-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KYLEE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "20636",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "17946",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770844144",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14240674",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Groveton, NH

Sources for this page

Verify at the official NPI Registry.