Individual provider Active NPI

Coral-Ann Roberts, PA-C

  • Physician Assistant
  • Terre Haute, IN
National Provider Identifier
1902567795
Registry record updated Jan 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004163A Issued in IN
Practice address
1606 N 7TH St
Terre Haute, IN 47804-2706
Phone
(812) 238-7000
NPI assigned
Jan 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.010047 IL
Physician Assistant 363A00000X 10004163A IN Primary

Addresses

Primary practice location

1606 N 7TH St
Terre Haute, IN 47804-2706

Mailing address

1606 N 7TH St
Terre Haute, IN 47804-2706
Phone (812) 238-7000

Other practice location 1

812 N Logan Ave
Danville, IL 61832-3752
Phone (214) 712-2789

Other practice location 2

1400 W Park St
Urbana, IL 61801-2334
Phone (217) 337-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231027002802 IL Practitioner - Physician Assistant 3870949712 Reassigns benefits to 1 organization
I20231220002864 IN Practitioner - Physician Assistant 3870949712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Dec 1, 2023 Accepting new patients
Cep America LLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705708800000",
    "number": "1902567795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 N 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042706",
            "telephone_number": "812-238-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 N 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042706",
            "telephone_number": "812-238-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 N Logan Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "IL",
            "postal_code": "618323752",
            "country_code": "US",
            "telephone_number": "214-712-2789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 W Park St",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "IL",
            "postal_code": "618012334",
            "country_code": "US",
            "telephone_number": "217-337-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CORAL-ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2024-01-20",
        "certification_date": "2024-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.010047",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004163A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.