J. GREGORY ROBERTS MD RVT (NPI# 1629103635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629103635 |
| Entity Type | Organization |
| Organization Name | J. GREGORY ROBERTS MD RVT |
| Other Organization Name | MANTLE CLINIC III |
| Practice Address |
223 Andrew Dr Oneida TN 37841 |
| Mailing Address |
1728 Falcon Pointe Dr Knoxville TN 37922-6397 |
| Practice Telephone | 8652186244 |
| Practice Fax Number | 8652186245 |
| Mailing Telephone | 8657423063 |
| Mailing Fax Number | 8652186244 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JAMES GREGORY ROBERTS (PHYSICIAN) |
| Authorized Official Telephone | 8652186244 |
| Authorized Official Credential | MD RVT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 37706 | TN | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | SOCIAL SECURITY NUMBER | $$$$$$$$$ | 01 |
| TN | RAILROAD MEDICARE | RAILROAD MEDICARE | 01 |
| TN | KENTUCKY MEDICAID | 64078132 | 01 |
| TN | 4069830 | BCBS | 01 |
| Other Name | Type Code |
|---|---|
| Mantle Clinic III | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356486252 | J. Gregory Roberts Md Rvt | Specialist | 10810 Parkside Dr, Suite 309, Knoxville, TN 37934-1979 | 2007-02-20 |
| Street Address |
223 ANDREW DR |
| City | ONEIDA |
| State | TN |
| Zip Code | 37841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811495161 | Kristin Alexis Henry | Physical Therapist | 530 Industrial Ln, Oneida, TN 37841 | 2018-01-31 |
| 1730504754 | Southern Psychiatric Services | Psychiatry & Neurology | 216 North Cross Street, Oneida, TN 37841 | 2014-02-27 |
| 1700142619 | Stephen Daniel Cross | Pharmacist | 20029 Alberta St., Oneida, TN 37841 | 2012-04-04 |
| 1730342700 | Ava Lynn Adcock | Speech-Language Pathologist | 127 Cross Street, Oneida, TN 37841 | 2008-07-09 |
| 1922289560 | Scott County Surgical Associates P.a. | Surgery | 615 N. Main Street, Oneida, TN 37841 | 2007-11-26 |
| 1205035185 | James Wyatt Denzler | Pharmacist | 19856 Alberta St, Oneida, TN 37841 | 2007-07-12 |
| 1073735569 | Dennis K Baird | Dentist | 204 South Bank Street, Oneida, TN 37841 | 2007-05-03 |
| 1790840767 | Synergistics, Inc. | Occupational Therapy Assistant | 125 Cross Street, Oneida, TN 37841 | 2006-12-27 |
| 1033282405 | Scott County Medical Clinic Inc | Clinic/Center | 19268 Alberta Ave, Oneida, TN 37841 | 2006-11-15 |
| 1912011792 | David Bruce Coffey | Family Medicine | 281 Underpass Drive, Oneida, TN 37841 | 2006-08-18 |
| Find all providers in zip 37841 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275769788 | Ellen Montana Lerner | Specialist | 297 Kenwood Ave, Apt C, Oneida, NY 13421-2821 | 2009-06-10 |
| 1225195324 | Nicki Rae Palmer | Specialist | 218 Liberty St, Oneida, NY 13421-1626 | 2007-01-02 |
| 1770583924 | Beverly Anne-marie Clark | Specialist | 321 Genesee St, Oneida, NY 13421 | 2005-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1487270963 | Daphne Hall | Specialist | 2504 Mount Moriah Rd Bldg D, Memphis, TN 38115-1519 | 2020-06-22 |
| 1235772435 | Cranial Prosthesis & Hair Loss Solutions LLC | Specialist | 310 S Walnut Bend Rd Ste 12, Cordova, TN 38018-7282 | 2019-10-21 |
| 1013481597 | Tiffany Powell | Specialist | 679 S Mendenhall Rd, Memphis, TN 38117-5212 | 2019-01-17 |
| 1619450160 | Lawrence Allan Claiborne | Specialist | 370 Morgan Rd, Greeneville, TN 37745-3118 | 2018-09-11 |
| 1740761949 | Anita Camille Henderson | Specialist | 718 Valencia Dr, Clarksville, TN 37043-2058 | 2018-08-24 |
| 1104311943 | I Am Tiara Mitchell | Specialist | 3913 Brainerd Rd, Chattanooga, TN 37411-3733 | 2018-06-25 |
| 1245735067 | Xclusive Kutz Barbershop | Specialist | 3610 Park Ave, Memphis, TN 38111-5630 | 2018-03-25 |
| 1083122642 | Daniela Kam | Specialist | 2615 Medical Center Pkwy Ste 1560, Murfreesboro, TN 37129-3758 | 2018-01-17 |
| 1871006924 | Jama'l Oliver | Specialist | 2038 Tynewood Dr, Clarksville, TN 37042-5285 | 2017-11-12 |
| 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.