Individual provider Active NPI

Rebecca Roberts, CRNP

  • Family Nurse Practitioner
  • Daphne, AL
National Provider Identifier
1942884028
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-162269 Issued in AL
Practice address
28150 N Main St
Daphne, AL 36526-7038
Phone
(251) 625-2400
NPI assigned
May 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-162269 AL Primary

Addresses

Primary practice location

28150 N Main St
Daphne, AL 36526-7038

Mailing address

28150 N Main St
Daphne, AL 36526-7038
Phone (251) 625-2400

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 2516252400

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1-162269ALMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1942884028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28150 N MAIN ST",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365267038",
            "telephone_number": "251-625-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28150 N MAIN ST",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365267038",
            "telephone_number": "251-625-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "REBECCA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-162269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "2516252400",
            "affiliation": "N",
            "endpointDescription": "Phone",
            "address_1": "28150 N Main St",
            "city": "Daphne",
            "state": "AL",
            "country_code": "US",
            "postal_code": "365267038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Daphne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.