Individual provider Active NPI

Sherrell L Roberts, MD

  • Internal Medicine Physician
  • Monticello, KY
National Provider Identifier
1780675801
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33071 Issued in KY
Practice address
1 S Creek Dr
Ste 102
Monticello, KY 42633-9472
Phone
(606) 348-3365
Fax
(606) 348-8496
NPI assigned
Oct 31, 2005
Last updated
Aug 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33071 KY Primary

Addresses

Primary practice location

1 S Creek Dr
Ste 102
Monticello, KY 42633-9472

Mailing address

1 S Creek Dr
Ste 102
Monticello, KY 42633-9472
Phone (606) 348-3365

Other identifiers 1

IdentifierTypeStateIssuer
64054521MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101008000363 KY Practitioner - Internal Medicine 6103018163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Louisville School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 S Creek Dr
Suite 102
Monticello, KY 42633-9472
Phone 60634833658

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sherrellroberts@mmaky.allscriptsdirect.net

Organizations & group practices 2

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 4

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1780675801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S CREEK DR",
            "address_2": "STE 102",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "426339472",
            "telephone_number": "606-348-3365",
            "fax_number": "606-348-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S CREEK DR",
            "address_2": "STE 102",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "426339472",
            "telephone_number": "606-348-3365",
            "fax_number": "606-348-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SHERRELL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "33071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64054521",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, KY

Sources for this page

Verify at the official NPI Registry.