Jarvis De'Kovan Roberts, DNP-FNP BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5020480 Issued in NC

Practice address

500 Iverson Way
Charlotte, NC 28203-5635

Phone

(803) 917-7736

NPI assigned

Jul 11, 2024

Sex

Male

Sole proprietor

No

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

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jroberts247066@carolinashealthcaresystem.direct-ci.com

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.

• Carolinas Emergency Physicians, P.a.

  • Emergency Medicine Physician
  • Kings Mountain, NC
  • NPI 1285952671
  Medicare reassignment NPD
• Carolinas Emergency Physicians, P.a.

  • Emergency Medicine Physician
  • Shelby, NC
  • NPI 1316264195
  NPD

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1932946498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 W 5TH AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524084",
            "telephone_number": "704-830-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 IVERSON WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035635",
            "telephone_number": "803-917-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JARVIS",
        "middle_name": "DE'KOVAN",
        "name_prefix": "Dr.",
        "credential": "DNP-FNP BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5020480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilee Roberts
• Gabrielle Roberts
• Jacquelyn Hensley Roberts, FNP-C
• Jada Roberts
• James K. Roberts, MD
• Jason Roberts
• Jason S Roberts, CRNA
• Jeanmarie Roberts, PMHNP-BC
• Jesse Elijah Roberts, MA, ED.S, NCC, LPCA
• Jessica Roberts, DC

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.

Verify at the official NPI Registry.