Richard Guy Roberts, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25691 Issued in WI

Practice address

21 S Vine St
Belleville, WI 53508-9179

Phone

(608) 424-3384

Fax

(608) 424-6353

NPI assigned

Sep 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1992792485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 S MILLS ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151849",
            "telephone_number": "608-263-3598",
            "fax_number": "608-263-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 S VINE ST",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089179",
            "telephone_number": "608-424-3384",
            "fax_number": "608-424-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "RICHARD",
        "middle_name": "GUY",
        "name_prefix": "Prof.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "25691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30531300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25691",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Marvin Pechacek, DPT
• Ashley Pierstorff, LPN
• Christa A Pittner-Smith, MD
• Makenzi Taylor Rasmussen, MSW
• Eric Raymond Reetz, MD
• April Ann Schleicher, MSE
• School District of Belleville
• Madeline Shay
• Elizabeth Renee Shelly, PT, DPT
• Angelie Singh, MD

• Family Medicine Physician in Belleville, WI
• Providers in Belleville, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.