Jenifer Ellen Roberts, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT000767 Issued in GA

Practice address

5616 La Roche Ave
Savannah, GA 31406-3115

Phone

(912) 656-8352

NPI assigned

Jun 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912102872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 LA ROCHE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063115",
            "telephone_number": "912-656-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5616 LA ROCHE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063115",
            "telephone_number": "912-656-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JENIFER",
        "middle_name": "ELLEN",
        "name_prefix": "Miss",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT000767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert B Miller DMD PC
• Alianna Roberts-Ocasio
• Alfred B Roberts III, DMD
• Casandra Roberts, PHARMD
• Deborah Roberts
• Julie Gumban Roberts, LCSW
• Kentaria Shantell Roberts, PTA
• Latoya Roberts
• Lindsey M Roberts, M.ED., CCC-SLP
• Lisa Roberts

• Athletic Trainer in Savannah, GA
• Providers in Savannah, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.