Amanda K. Roberts, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E-6791 Issued in AR

Practice address

2301 Springhill Road
Ste 200
Benton, AR 72019

Phone

(501) 315-0078

Fax

(501) 943-3016

NPI assigned

Apr 14, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amanda K. Merrick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Central Arkansas Pediatric Clinic

  • Legal Medicine
  • Benton, AR
  • NPI 1124057088
  NPD (past)

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1831363654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 SPRINGHILL ROAD",
            "address_2": "SUITE 200",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72019",
            "telephone_number": "501-315-0078",
            "fax_number": "501-943-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 SPRINGHILL ROAD",
            "address_2": "STE 200",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72019",
            "telephone_number": "501-315-0078",
            "fax_number": "501-943-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "AMANDA",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-6791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186469001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MERRICK",
            "middle_name": "K.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christy Roark
• Kenneth Roaten Jr., CMP
• Anita Jo Roberson, PHARMD
• Robert a. Council, Jr., MD, PA
• Robert R. Carlisle, D.D.S.
• Jessica Roberts, LAC
• Kelsey Roberts
• Shannon Laurel Roberts, PT, DPT
• Katherine Isabelle Robertson
• Kenzie Robinson, CMP

• Pediatrics Physician in Benton, AR
• Providers in Benton, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.