DR. E. DWAIN ROBERTS (NPI# 1013997782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013997782 |
| Entity Type | Individual |
| Full Name | DR. E. DWAIN ROBERTS |
| Credential | M.D. |
| Practice Address |
1241 W Stadium Blvd Jefferson City MO 65109-6023 |
| Mailing Address |
Po Box 104240 Jefferson City MO 65110-4240 |
| Practice Telephone | 5735567755 |
| Practice Fax Number | 5737613599 |
| Mailing Telephone | 5735567755 |
| Mailing Fax Number | 5737613599 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2008-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
114884 | MO | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
114884 | MO | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
114884 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | RAILROAD MEDICARE | 300090314 | 01 |
| MO | 209786607 | 05 | |
| MO | GROUP RR | DB1586 | 01 |
| MO | RR GROUP | CC7852 | 01 |
| MO | IND. RR | P00201659 | 01 |
| Street Address |
1241 W STADIUM BLVD |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-6023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801899851 | Robert E Ferris | Specialist | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2005-05-23 |
| 1013542109 | Ashlee Kathleen Parkes | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2020-03-09 |
| 1508498601 | Samantha Michelle Findley | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2020-02-06 |
| 1891335360 | Carson Mikaela Borgmeyer | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2020-01-13 |
| 1215570585 | Cortny Osie-ann Vandergrift | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-10-19 |
| 1912569906 | Sarah Loveland Jennett | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-07-01 |
| 1699339754 | Sumnima Neupane | Nurse Anesthetist, Certified Registered | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-04-24 |
| 1720545999 | Angela Kay Watkins | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-02-25 |
| 1811471667 | Morgan Elizabeth Grace Su | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2018-09-18 |
| 1780105007 | Jennifer Lynn Adelman | Registered Nurse | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2017-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449321 | Kara D Roderick | Physical Therapist | 1115 Fairgrounds Road, Jefferson City, MO 65109 | 2018-08-29 |
| 1851871214 | Integrative Medicine, LLC | Internal Medicine | 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 | 2018-08-15 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1124558986 | Nicholas Rehagen | Specialist/Technologist | 304 Timber Creek Rd, Jefferson City, MO 65109 | 2017-06-14 |
| 1982004214 | Kara Elizabeth Wilbers | Occupational Therapist | 1105 Fairgrounds Rd, Jefferson City, MO 65109 | 2014-08-22 |
| 1942510334 | Loftin Eyecare, LLC | Optometrist | 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 | 2010-10-19 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972730141 | Nancy S Stork | Counselor | 204 Metro, Suite B, Jefferson City, MO 65109 | 2009-06-16 |
| 1356522916 | Walk Easy LLC | Durable Medical Equipment & Medical Supplies | 4810 Rainbow Dr., Jefferson City, MO 65109 | 2007-11-23 |
| Find all providers in zip 65109 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487012142 | Correctional Medical Imaging, Inc. | Radiology | 1001 Southwest Blvd Ste C, Jefferson City, MO 65109-2501 | 2016-02-09 |
| 1477818698 | Correctional Medical Imaging, Inc. | Radiology | 2713 Industrial Dr Ste C, Jefferson City, MO 65109-6705 | 2012-07-13 |
| 1568621175 | Advanced Radiology of Jefferson City, LLC | Radiology | 3218 W Edgewood Dr Ste 200, Jefferson City, MO 65109-6951 | 2008-06-09 |
| 1114025079 | Donald K Mcnutt | Radiology | 2713 Industrial Dr, Suite C, Jefferson City, MO 65109-6705 | 2006-09-21 |
| 1700043791 | Capital Region Medical Center | Radiology | 1125 Madison St, Jefferson City, MO 65102-5227 | 2008-05-19 |
| 1366508327 | Jefferson City Medical Group, P.C. | Radiology | 1241 W Stadium Blvd, Lower Level, Jefferson City, MO 65109-6023 | 2006-12-27 |
| 1558455196 | Mitchell Teruichi Godbee | Radiology | 1125 Madison St, Jefferson City, MO 65101-5227 | 2006-10-03 |
| 1861583544 | Marcus Jerome Wade | Radiology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2006-09-27 |
| 1508964479 | Denzil J. Hawes-davis | Radiology | 1125 Madison St, Jefferson City, MO 65101-5227 | 2006-09-21 |
| 1235238056 | Missouri Medical Imaging, Inc. | Radiology | 1125 Madison St, Jefferson City, MO 65101-5227 | 2006-09-21 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
Please comment or provide details below to improve the information on DR. E. DWAIN 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.