Kevin Mathis Roberts, A.T.,C. , M ED.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

10590 Town Center Dr Ste 100
Rancho Cucamonga, CA 91730-0361

Phone

(909) 948-1124

NPI assigned

Apr 13, 2010

Sex

Male

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

Credentials

Master of Education

Practice roles

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.

• Team Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Rancho Cucamonga, CA
  • NPI 1205869070
  NPD (past)

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271116800000",
    "number": "1912223165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10590 TOWN CENTER DR STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300361",
            "telephone_number": "909-948-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 TOWN CENTER DR STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300361",
            "telephone_number": "909-948-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KEVIN",
        "middle_name": "MATHIS",
        "name_prefix": "Mr.",
        "credential": "A.T.,C.  ,  M ED.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Anne Darcy Roark
• Donna Vest Robbins, SLP
• Emma Roberson
• Cadynce Roberts
• Jamie Danielle Roberts, M.A.
• Lisa L Roberts
• Marilyn Roberts, RPA
• Tanisha N Roberts, R.T
• Robinhood Enterprises Inc.
• Anjanette M. Robinson, RBT

• Athletic Trainer in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; 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.