Active NPI
Erin M Roberts, FNP
- Family Nurse Practitioner
- Clinton, CT
National Provider Identifier
1912239476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 6106
- Practice address
- 114 E Main St
Clinton, CT 06413-2112 - Phone
- (860) 664-0787
- Fax
- (860) 664-1982
- NPI assigned
- Feb 9, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704243791 | MI | |
| Family Nurse Practitioner | 363LF0000X | 6106 | CT | Primary |
Addresses
Primary practice location
114 E Main St
Clinton, CT 06413-2112
Mailing address
120 N Delaware St
Suite 1
Sandusky, MI 48471-1009
Phone (810) 648-3770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160105000895 | CT | Order and Referring Only - Nurse Practitioner | 5496888737 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704243791 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McKenzie Memorial Hospital | Family | Past | Accepting new patients |
Organizations & group practices 1
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": "1265673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1912239476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 N DELAWARE ST",
"address_2": "SUITE 1",
"city": "SANDUSKY",
"state": "MI",
"postal_code": "484711009",
"telephone_number": "810-648-3770",
"fax_number": "810-648-3352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 E MAIN ST",
"city": "CLINTON",
"state": "CT",
"postal_code": "064132112",
"telephone_number": "860-664-0787",
"fax_number": "860-664-1982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "ERIN",
"middle_name": "M",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-09",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704243791",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "6106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clinton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.