Tisa O Roberts, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2006-01513 Issued in NC

Practice address

1041 Noell LN
Medical Plaza B
Rocky Mount, NC 27804-2058

Phone

(252) 316-8205

Fax

(252) 962-3451

NPI assigned

Feb 13, 2007

Last updated

Oct 2, 2020By the provider in NPPES

Sex

Female

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Colorado School of Medicine, Denver, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Opportunities Industrialization Center, IncGroup PAC ID 3173563590, shared by 6 NPIs, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unc Health Nash Hospital, Rocky Mount, NC, CCN 340147

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Opportunities Industrialization Center, Inc

  dba Oic Family Medical Center at Happy Hill

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
  • NPI 1528478237
  Medicare reassignment NPD
• Opportunities Industrialization Center, Inc

  dba OIC Sunset Avenue

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
  • NPI 1578219424
  Medicare reassignment NPD
• Opportunities Industrialization Center, Inc

  dba OIC Specialty Care Center

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
  • NPI 1639661796
  Medicare reassignment NPD
• Opportunities Industrialization Center, Inc.

  dba Oic Family Medical Center Guardian Court

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
  • NPI 1396103305
  Medicare reassignment NPD
• Opportunities Industrialization Center, Inc.

  dba OIC Family Medical Center at Community Health Plaza

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
  • NPI 1750734307
  Medicare reassignment NPD
• Johnston Primary Care Physician Services Inc

  dba Johnston Medical Associates

  • Family Medicine Physician
  • Smithfield, NC
  • NPI 1841455755
  NPD (past)
• Jones Outreach Services, LLP

  • Mental Health Counselor
  • Zebulon, NC
  • NPI 1982902052
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Nash Hospitals Inc

  dba Nash General Hospital

  • General Acute Care Hospital
  • Rocky Mount, NC
  • NPI 1619969219
  Care Compare affiliation

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1942342159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2723",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278022723",
            "telephone_number": "252-212-6802",
            "fax_number": "252-212-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 NOELL LN",
            "address_2": "MEDICAL PLAZA B",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042058",
            "telephone_number": "252-316-8205",
            "fax_number": "252-962-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TISA",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2006-01513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rising Kings Youth Home LLC
• Rite Aid
• Alvaro Joel Rivero Rojas, APRN
• Nora Priscilla Roberson
• Joseph Edward Roberts, M.D.
• Thomas J Robertson Jr., M.D.
• Eboni' Nicole Robinson
• Kimberly Alexis Robinson, MSW
• Mary Robinson
• Rocky Mount Assisted Living and Memory Care, LLC

• Family Medicine Physician in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.