LILLY IDA ROBERTS (NPI# 1922003169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922003169 |
| Entity Type | Individual |
| Full Name | LILLY IDA ROBERTS |
| Credential | APN |
| Practice Address |
322 Dogwood Hollow Rd Mountain View AR 72560-8626 |
| Mailing Address |
Po Box 1060 Marshall AR 72650-1060 |
| Practice Telephone | 8702692995 |
| Practice Fax Number | 8702692991 |
| Mailing Telephone | 8704485733 |
| Mailing Fax Number | 8704485736 |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | A01186 ANP | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUECROSS OF ARKANSAS | 54041B477 | 01 |
| AR | RAILROAD MEDICARE | P000014273 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2263 Hwy 65 North, Marshall, AR 726501266 | 8704485733 | 8704485736 |
| Street Address |
322 DOGWOOD HOLLOW RD |
| City | MOUNTAIN VIEW |
| State | AR |
| Zip Code | 72560-8626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982149662 | Boston Mountain Rural Health Center, Inc | Clinic/Center | 322 Dogwood Hollow Rd, Mountain View, AR 72560-8626 | 2017-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979781 | Creoks Mental Health Services, Inc | Clinic/Center | 301 Industrial Road, Mountain View, AR 72560 | 2020-07-14 |
| 1194377861 | John Randolph Crone II | Physical Therapist | 103 Mountain Place Drive, Mountain View, AR 72560 | 2019-07-12 |
| 1154898161 | Candace Casey Lane | Physical Therapy Assistant | 260 Hickory Circle, Mountain View, AR 72560 | 2018-10-29 |
| 1780102210 | Janet Karen Watkins | Developmental Therapist | 1810 Ozarka College Drive, Mountain View, AR 72560 | 2017-09-05 |
| 1861928038 | Jason Nope | Registered Nurse | 217 Brewer Avenue, Mountain View, AR 72560 | 2017-05-10 |
| 1013377415 | Charles Grinder | Nurse Practitioner | 102 Mountain Place Dr Ste C, Mountain View, AR 72560 | 2016-02-26 |
| 1912365982 | Baxter Regional Health System | Family Medicine | 102 Mountain Place Drive, Suite C, Mountain View, AR 72560 | 2016-02-05 |
| 1790142859 | Baxter Regional Health System | Nurse Practitioner | 803 W Main St., Mountain View, AR 72560 | 2016-01-20 |
| 1518337732 | Beverly Clark | Nurse Practitioner | 803 West Main Street, Mountain View, AR 72560 | 2015-09-30 |
| 1447503941 | Mitchell's Main Street Pharmacy, Inc | Pharmacy | 214 East Main St, Mountain View, AR 72560 | 2012-10-22 |
| Find all providers in zip 72560 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194761296 | Cynthia Shinchyi Yu | Nurse Practitioner | 100 Moffett Blvd, Ste 101, Mountain View, CA 94043-4721 | 2006-06-20 |
| 1740892579 | Lauren Suzanne Masio | Nurse Practitioner | 701 E El Camino Real, Mountain View, CA 94040-2833 | 2020-08-22 |
| 1679112353 | Kristy Ahn Lu | Nurse Practitioner | 580 N Rengstorff Ave, Mountain View, CA 94043-2894 | 2019-12-30 |
| 1225538762 | Karen Siu | Nurse Practitioner | 701 E El Camino Real, Mountain View, CA 94040-2833 | 2018-02-20 |
| 1679086847 | Stephanie J Cheng | Nurse Practitioner | 701 E El Camino Real, Mountain View, CA 94040-2833 | 2017-11-09 |
| 1720509193 | Aparna Bhandarkar | Nurse Practitioner | 2485 Hospital Dr Ste 330, Mountain View, CA 94040-4103 | 2017-07-06 |
| 1497153282 | Yunghui Lin | Nurse Practitioner | 701 E El Camino Real, Mountain View, CA 94040-2833 | 2014-12-11 |
| 1801209077 | Erin Labmeier | Nurse Practitioner | 701 E El Camino Real, Mountain View, CA 94040-2833 | 2014-06-05 |
| 1265783880 | Valentino A Demayo | Nurse Practitioner | 701 E El Camino Real, Mountain View, CA 94040-2833 | 2012-09-21 |
| 1790091478 | Tsaiti Chen | Nurse Practitioner | 701 E El Camino Real, Mountain View, CA 94040-2833 | 2010-08-19 |
| Find all providers in MOUNTAIN VIEW | ||||
| City | MOUNTAIN VIEW |
| Zip Code | 72560 |
Please comment or provide details below to improve the information on LILLY IDA ROBERTS.
| 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.