Individual provider Active NPI

Cynthia E Roberts, FNP-BC

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1942488457
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
112198 Issued in MO
Practice address
4055 Valley View LN Ste 400
Dallas, TX 75244-5071
Phone
(877) 570-9359
NPI assigned
Feb 6, 2008
Last updated
Sep 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 46148 KS
Nurse Practitioner 363L00000X 112198 MO Primary

Addresses

Primary practice location

4055 Valley View LN Ste 400
Dallas, TX 75244-5071

Mailing address

4 River Ridge Ter
Saint Joseph, MO 64507-7761
Phone (816) 344-4439

Other practice location 1

7500 Wornall Rd
Kansas City, MO 64114-1816
Phone (855) 925-4733

Other identifiers 3

IdentifierTypeStateIssuer
200601490AMedicaidKS
P00735197OtherMORR MEDICARE
208332304MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
46148KSMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: cindy.roberts@direct.mymlc.com
  • Direct secure messaging: cynthia.roberts@hca2.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1942488457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RIVER RIDGE TER",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645077761",
            "telephone_number": "816-344-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445071",
            "telephone_number": "877-570-9359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7500 Wornall Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641141816",
            "country_code": "US",
            "telephone_number": "855-925-4733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CYNTHIA",
        "middle_name": "E",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "46148",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "112198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200601490A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00735197",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208332304",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.