MRS. ELLEN H ROBERTS IV (NPI# 1134155310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134155310 |
| Entity Type | Individual |
| Full Name | MRS. ELLEN H ROBERTS IV |
| Practice Address |
3072 Old Pendergrass Rd Jefferson GA 30549-7508 |
| Practice Telephone | 7063674377 |
| Practice Fax Number | 7063674377 |
| Mailing Telephone | 7063674377 |
| Mailing Fax Number | 7063674377 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902109937 | Ellen Swain Roberts | Speech-Language Pathologist | 85 Reddick Ln, Rochester, NY 14624-1959 | 2010-12-14 |
| 1255453585 | Ellen Karen Roberts | Speech-Language Pathologist | 4650 W Sweetwater, Glendale, AZ 85304 | 2007-04-06 |
| 1295385441 | Ellen Roberts | Counselor | 615 Piikoi St Ste 203, Honolulu, HI 96814-3139 | 2019-09-18 |
| 1114422789 | Ellen Irene Roberts | Student in an Organized Health Care Education/Training Program | 123 Summer St, Worcester, MA 01608-1216 | 2018-03-27 |
| 1063655991 | Ellen Brattain Roberts | Nurse Practitioner | 702 Barnhill Dr, Room 2500, Indianapolis, IN 46202-5128 | 2009-04-08 |
| 1548423569 | Ellen Roberts | Social Worker | 321 Price St, Friday Harbor, WA 98250-9606 | 2008-07-09 |
| 1245448299 | Ellen B Roberts | Physical Therapist | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2007-05-21 |
| 1770534828 | Ellen K Roberts | Anesthesiology | 988102 Nebraska Medical Ctr, Omaha, NE 68198-8102 | 2006-05-13 |
| 1346224342 | Ellen Goff Roberts | Radiology | 100 Sterling Way, Ste 1, Mt Sterling, KY 40353 | 2005-12-02 |
| Street Address |
3072 OLD PENDERGRASS RD |
| City | JEFFERSON |
| State | GA |
| Zip Code | 30549-7508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356723464 | Lindsey Marie Whitworth | Pharmacist | 918 Old Forge Lane, Jefferson, GA 30549 | 2015-06-25 |
| 1780835876 | Jeanna Ellis | Pharmacist | 1305 Washington St., Jefferson, GA 30549 | 2008-10-07 |
| 1578769246 | William Robert Newell | Dentist | 1689 Old Pendergrass Rd., Suite 350, Jefferson, GA 30549 | 2007-06-21 |
| 1003950825 | Regional Firstcare | Emergency Medicine | 528 Panther Drive, Jefferson, GA 30549 | 2007-02-16 |
| 1629118096 | Susan Marie Bell | Dietitian, Registered | 341 General Jackson Drive, Jefferson, GA 30549 | 2007-02-07 |
| 1538254008 | Douglas E Cleveland | Dentist | 411 Athens Street, Jefferson, GA 30549 | 2006-10-03 |
| 1740382894 | Tammy G Smith | Clinic/Center | 2610 Hwy 129 N, Jefferson, GA 30549 | 2006-09-01 |
| 1881641264 | Peak Rehabilitation, Inc | Clinic/Center | 1660 Washington St, Jefferson, GA 30549 | 2006-05-30 |
| 1801372578 | Stephen Edward Conwell | Nurse Practitioner | 1685 Old Pendergrass Rd, Jefferson, GA 30549 | 2018-07-16 |
| 1255871992 | Life Point Dental | Clinic/Center | 660 Washington St., Jefferson, GA 30549 | 2017-02-28 |
| Find all providers in zip 30549 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900011 | Tamekia Richardson | Contractor | 861 Frank Rd, Fitzgerald, GA 31750-9049 | 2020-10-20 |
| 1285232777 | Khrystal Wright | Contractor | 4016 Foxborough Blvd, Valdosta, GA 31602-6726 | 2020-10-15 |
| 1922605690 | Mary Sonya Jackson | Contractor | 5480 Hedge Brooke Pointe Nw, Acworth, GA 30101-7142 | 2020-10-06 |
| 1790392652 | Najee Shafi | Contractor | 100 Archstone Sq, Mcdonough, GA 30253-5820 | 2020-09-24 |
| 1144837071 | Angela M Bodie | Contractor | 406 Carrington Green Pkwy, Mcdonough, GA 30252-7693 | 2020-09-24 |
| 1841806841 | Ashley De Plato | Contractor | 3813 Robin Ln, Valdosta, GA 31605-5124 | 2020-09-16 |
| 1407462401 | Pamela Woodard | Contractor | 868 Cochise Trl Se, Conyers, GA 30094-4538 | 2020-09-16 |
| 1821603606 | Sherenda Lashawn Ellis | Contractor | 1859 Petite Lane, Lithonia, GA 30058 | 2020-09-09 |
| 1316551377 | Holland Consulting Practice LLC | Contractor | 6307 Towne Lake Hts, Woodstock, GA 30189-4245 | 2020-09-07 |
| 1003420571 | Antonio Jones | Contractor | 700 Martin Luther King Jr Dr Sw Apt 206, Atlanta, GA 30314-4143 | 2020-09-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.