Organization Active NPI

Enid Roberts MD PLLC

  • Obstetrics & Gynecology Physician
  • Chesterfield, MI
National Provider Identifier
1861661985
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301057945 Issued in MI
Legal business name
ENID ROBERTS MD PLLC
Practice address
33497 23 Mile Rd
Suite 160
Chesterfield, MI 48047-4062
Phone
(586) 716-1702
Fax
(586) 716-1706
NPI assigned
Feb 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Authorized official

Name
Dr. Enid Roberts, MDNPI 1164445748
Title
Physcian/Owner
Phone
(586) 716-1702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 4301057945 MI Primary

Addresses

Primary practice location

33497 23 Mile Rd
Suite 160
Chesterfield, MI 48047-4062

Mailing address

PO Box 99251
Troy, MI 48099-9251
Phone (586) 716-1702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050316000093 MI Part B Supplier - Clinic/Group Practice 5698720316 Receives reassigned benefits from 1 practitioner
Practice locations: Chesterfield, MI

National Provider Directory

National Provider Directory

Locations

33497 23 Mile Rd
Ste 160
Chesterfield, MI 48047
Phone (586) 716-1702

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1861661985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99251",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480999251",
            "telephone_number": "586-716-1702",
            "fax_number": "586-716-1706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33497 23 MILE RD",
            "address_2": "SUITE 160",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480474062",
            "telephone_number": "586-716-1702",
            "fax_number": "586-716-1706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENID ROBERTS MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "ENID",
        "authorized_official_title_or_position": "PHYSCIAN/OWNER",
        "authorized_official_telephone_number": "586-716-1702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301057945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.