NPIMap

Individual provider Active NPI

Victoria Anderson Roberts, PA-C

  • Physician Assistant
  • Chapin, SC
National Provider Identifier
1982247383
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
104 Ellett Rd
Chapin, SC 29036-8604
Phone
(803) 941-8095
NPI assigned
Oct 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

104 Ellett Rd
Chapin, SC 29036-8604

Mailing address

104 Ellett Rd
Chapin, SC 29036-8604
Phone (803) 941-8095

Other practice location 1

2605 Kinard St Ste 105
Newberry, SC 29108-2965
Phone (803) 321-6254

Other identifiers 1

IdentifierTypeStateIssuer
4238PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200817002155 SC Practitioner - Physician Assistant 8527484955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Palmetto Bone and JointGroup PAC ID 4385545565, 12 clinicians

Practice addresses (Care Compare)

104 Ellett Rd
Chapin, SC 29036-8604
Phone (864) 833-3046

22971 Hwy 76 E
Clinton, SC 29325
Phone (864) 833-3046

2704 Kinard St
Newberry, SC 29108-2908
Phone (803) 321-6254

Hospital & facility affiliations

  • Newberry County Memorial Hospital Hospital, Newberry, SC, CCN 420053
  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071
  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1982247383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ELLETT RD",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368604",
            "telephone_number": "803-941-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ELLETT RD",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368604",
            "telephone_number": "803-941-8095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2605 Kinard St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Newberry",
            "state": "SC",
            "postal_code": "291082965",
            "country_code": "US",
            "telephone_number": "803-321-6254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "VICTORIA",
        "middle_name": "ANDERSON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-18",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4238PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapin, SC

Sources for this page

Verify at the official NPI Registry.