Jessica G Roberts, MD, PC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD23993 Issued in OR

Legal business name

JESSICA G ROBERTS, MD, PC

Practice address

4805 NE Glisan St
Portland, OR 97213-2933

Phone

(503) 319-4966

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jessica Roberts, MD

Title

Owner

Phone

(503) 319-4966

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811086747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3439 NE SANDY BLVD",
            "address_2": "PMB 375",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321959",
            "telephone_number": "503-284-8841",
            "fax_number": "503-282-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-319-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA G ROBERTS, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-319-4966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "MD23993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286343",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tricia N Jesperson, DO
• Terry Edward Jess, RN
• Peter Jessel, M.D.
• Jessica Blaylock Dba Fusion Bodyworks PDX
• Jessica Brooke Huffman, LLC
• Jessica Hammond Therapy LLC
• Jessica Kieras LLC
• Cynthia Ann Jessie
• Brisa Salome Jessup, NP
• Stephanie Marie Humiwat Jessup

• Child & Adolescent Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Child & Adolescent Psychiatry Physician in Oregon

• 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.