Active NPI
Justin Roberts, NP-C
- Gerontology Nurse Practitioner
- Muskogee, OK
National Provider Identifier
1962953158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 84805
- Practice address
- 333 S 38TH St Ste E
Muskogee, OK 74401-4937 - Phone
- (918) 910-5391
- Fax
- (918) 910-5395
- NPI assigned
- Oct 22, 2016
- Last updated
- Oct 22, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 84805 | OK | |
| Gerontology Nurse Practitioner | 363LG0600X | 84805 | OK | Primary |
Addresses
Primary practice location
333 S 38TH St Ste E
Muskogee, OK 74401-4937
Mailing address
333 S 38TH St Ste E
Muskogee, OK 74401-4937
Phone (918) 910-5391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3330 W Okmulgee St
Muskogee, OK 74401-5069
Phone (918) 682-4318
Hospital & facility affiliations
- Carter Heathcare of McAlester, LLC
- Enhabit Home Health of Eastern Oklahoma
- A Path of Care Sooner Home Health
- Elara Caring Xviii
- Saint Francis Hospital Muskogee
- Saint Francis Hospital, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Muskogee Family Medicine, LLC | Current | Accepting new patients | |
| Warren Clinic Inc | Past | Accepting new patients | |
| Green Country Infectious Disease PC | Past | Accepting new patients |
Locations
3330 W Okmulgee St
Muskogee, OK 74401
Phone (918) 682-4318
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FDHDDD
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Muskogee, OK
- NPI 1790891505
-
- Infectious Disease Physician
- Broken Arrow, OK
- NPI 1639639321
-
- General Practice Physician
- Tulsa, OK
- NPI 1174582282
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Muskogee, OK
- NPI 1841415254
-
dba Carter Healthcare
- Home Health Agency
- Tahlequah, OK
- NPI 1043582018
-
dba Enhabit Home Health of Eastern Oklahoma
- Home Health Agency
- Muskogee, OK
- NPI 1306826698
-
dba Saint Francis Hospital Muskogee
- General Acute Care Hospital
- Muskogee, OK
- NPI 1386188837
-
- Rehabilitation Hospital Unit
- Tulsa, OK
- NPI 1003039488
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1144228487
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477094400000",
"number": "1962953158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 S 38TH ST STE E",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744014937",
"telephone_number": "918-910-5391",
"fax_number": "918-910-5395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 S 38TH ST STE E",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744014937",
"telephone_number": "918-910-5391",
"fax_number": "918-910-5395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JUSTIN",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-22",
"last_updated": "2016-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OK",
"license": "84805",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "OK",
"license": "84805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2016; 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.