Individual provider Active NPI

Krista Jean Roberts, NP

  • Family Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1790206266
Registry record updated Sep 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R234479 Issued in MD
Practice address
1616 Forest Dr Ste 1
Annapolis, MD 21403-1019
Phone
(410) 263-4400
NPI assigned
Jul 5, 2017
Last updated
Sep 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R234479 MD Primary

Addresses

Primary practice location

1616 Forest Dr Ste 1
Annapolis, MD 21403-1019

Mailing address

1616 Forest Dr Ste 1
Annapolis, MD 21403-1019
Phone (410) 263-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180924002137 MD Practitioner - Nurse Practitioner 5597016022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians

Practice addresses (Care Compare)

1616 Forest Dr
Suite 1
Annapolis, MD 21403-1019
Phone (410) 263-4400

301 Saint Paul St
Suite 409
Baltimore, MD 21202-2102
Phone (410) 659-7041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Apr 14, 2019 Accepting new patients
Privia Care Center LLC CurrentSince Apr 14, 2019 Accepting new patients
Privia Care Center LLC CurrentSince Apr 14, 2019 Accepting new patients
Privia Medical Group, LLC CurrentSince Apr 14, 2019 Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

1616 Forest Dr
Ste 1
Annapolis, MD 21403
Phone (410) 263-4400

301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041

Interoperability endpoints

  • Direct secure messaging: krista.roberts.1@8042.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568419200000",
    "number": "1790206266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 FOREST DR STE 1",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214031019",
            "telephone_number": "410-263-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 FOREST DR STE 1",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214031019",
            "telephone_number": "410-263-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KRISTA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2019-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R234479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.