Individual provider Active NPI

Terri Roberts, NP

  • Adult Health Nurse Practitioner
  • Chippewa Falls, WI
National Provider Identifier
1841613148
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
126389-30 Issued in WI
Practice address
2661 Cty Hwy I
Chippewa Falls, WI 54729
Phone
(715) 717-7485
NPI assigned
Jan 23, 2014
Last updated
Dec 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 126389-30 WI Primary

Addresses

Primary practice location

2661 Cty Hwy I
Chippewa Falls, WI 54729

Mailing address

PO Box 161
212 South 3Rd Street
Cornell, WI 54732
Phone (715) 202-3256

Other practice location 1

906 College Ave W
Ladysmith, WI 54848
Phone (715) 532-2300

Other practice location 2

900 W Clairemont Ave
Eau Claire, WI 54701-6122
Phone (715) 717-4121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20140313001498 WI Practitioner - Nurse Practitioner 7810127883 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Black River Health Inc CurrentSince Dec 1, 2020 Accepting new patients
Black River Health Inc CurrentSince Dec 1, 2020 Accepting new patients
Oak Medical SC CurrentSince Jun 1, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince May 15, 2023 Accepting new patients
Black River Health Inc Current Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

1110 Kepler Dr
Green Bay, WI 54311
Phone (920) 288-4712

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

Organizations & group practices 5

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": "1390435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1841613148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161",
            "address_2": "212 SOUTH 3RD STREET",
            "city": "CORNELL",
            "state": "WI",
            "postal_code": "54732",
            "telephone_number": "715-202-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 CTY HWY I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "54729",
            "telephone_number": "715-717-7485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "906 College Ave W",
            "address_purpose": "LOCATION",
            "city": "Ladysmith",
            "state": "WI",
            "postal_code": "54848",
            "country_code": "US",
            "telephone_number": "715-532-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 W Clairemont Ave",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016122",
            "country_code": "US",
            "telephone_number": "715-717-4121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TERRI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-23",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "126389-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

Verify at the official NPI Registry.