Individual provider Active NPI

Stephanie Roberson

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1861807992
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0614994 Issued in AL
Practice address
440 Taylor Rd
Ste 3380
Montgomery, AL 36117-3588
Phone
(334) 213-6255
Fax
(334) 213-6243
NPI assigned
Jun 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 1-122680 AL
Family Nurse Practitioner 363LF0000X F0614994 AL Primary

Addresses

Primary practice location

440 Taylor Rd
Ste 3380
Montgomery, AL 36117-3588

Mailing address

40 Village CT
Wetumpka, AL 36093-2982
Phone (334) 590-1699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20141003000965 AL Practitioner - Nurse Practitioner 8426278979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Contracting Services LLCGroup PAC ID 3971417825, 404 clinicians

Practice addresses (Care Compare)

2105 E S Blvd
Montgomery, AL 36116-2409
Phone (334) 288-2100

810 Saint Vincents Dr
Birmingham, AL 35205-1601
Phone (205) 939-7100

Hospital & facility affiliations

  • Baptist Medical Center South Hospital, Montgomery, AL, CCN 010023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F0614994ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Services of Montgomery PC CurrentSince Aug 1, 2014 Accepting new patients
Paragon Contracting Services LLC CurrentSince Jun 14, 2021 Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

Interoperability endpoints

  • Direct secure messaging: stephanie.roberson@direct.baptistfirst.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1861807992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 VILLAGE CT",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360932982",
            "telephone_number": "334-590-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 TAYLOR RD",
            "address_2": "STE 3380",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173588",
            "telephone_number": "334-213-6255",
            "fax_number": "334-213-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "AL",
            "license": "1-122680",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "F0614994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.