MR. KENNETH M. ROBERTS (NPI# 1285748954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285748954 |
| Entity Type | Individual |
| Full Name | MR. KENNETH M. ROBERTS |
| Credential | P.A. |
| Practice Address |
300 Clyde Morris Blvd Suite C Ormond Beach FL 32174-5956 |
| Practice Telephone | 3866735100 |
| Practice Fax Number | 3866736014 |
| Mailing Telephone | 3866735100 |
| Mailing Fax Number | 3866736014 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-05-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124678578 | Kenneth Andre Roberts II | Dietitian, Registered | 110 Mascoutah Ave, Belleville, IL 62220-3801 | 2019-09-18 |
| 1801359559 | Kenneth Wayne Roberts | Student in an Organized Health Care Education/Training Program | Aventura Hospital & Medical Center, 20900 Biscayne Blvd, Aventura, FL 33138 | 2019-04-10 |
| 1801157805 | Kenneth James Roberts Jr. | Massage Therapist | 9420 Towne Square Ave, Suite #3, Blue Ash, OH 45242-6922 | 2012-06-06 |
| 1124245006 | Kenneth Wayne Roberts | Dentist | 546 N Lafayette St, South Lyon, MI 48178-2000 | 2007-04-20 |
| 1194890848 | Kenneth C Roberts | Internal Medicine | 400 Veterans, Biloxy, MS 39531 | 2006-11-21 |
| 1598732521 | Kenneth E. Roberts | Family Medicine | 287 Healthwest Dr, Dothan, AL 36303-2031 | 2006-03-08 |
| 1285991620 | Kenneth Latroye Roberts | Counselor | 3435 W Shaw Ave, Ste. 101, Fresno, CA 93711-3234 | 2012-04-23 |
| 1740503556 | Kenneth Lewis Roberts | Counselor | 366 Prior Ave N, Saint Paul, MN 55104-5165 | 2010-03-08 |
| 1740329028 | Kenneth Eugene Roberts | Social Worker | 620 5th Avenue, Fairbanks, AK 99701 | 2007-02-05 |
| 1144264946 | Kenneth Barry Roberts | Pediatrics | 1200 N Elm St, Greensboro, NC 27401-1004 | 2006-06-15 |
| Street Address |
300 CLYDE MORRIS BLVD SUITE C |
| City | ORMOND BEACH |
| State | FL |
| Zip Code | 32174-5956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982692943 | Gastroenterology Consultants, P.a. | Specialist | 300 Clyde Morris Blvd, Suite A, Ormond Beach, FL 32174-5956 | 2005-10-12 |
| 1336286251 | Florida Urology Center Pa | Urology | 300 Clyde Morris Blvd, Suite C, Ormond Beach, FL 32174-5956 | 2007-01-31 |
| 1669483137 | Physicians Ambulatory Surgery Center Inc | Clinic/Center | 300 Clyde Morris Blvd, Suite B, Ormond Beach, FL 32174-5956 | 2006-08-10 |
| 1194765495 | Gregory Alan Parr | Urology | 300 Clyde Morris Blvd, Suite C, Ormond Beach, FL 32174-5956 | 2006-06-07 |
| 1831136977 | Bert Maurice Morrow | Urology | 300 Clyde Morris Blvd, Suite C, Ormond Beach, FL 32174-5956 | 2006-05-31 |
| 1679520977 | Dane Kartsen Hermansen | Urology | 300 Clyde Morris Blvd, Suite C, Ormond Beach, FL 32174-5956 | 2006-05-30 |
| 1164479598 | Jay Christian Guido | Urology | 300 Clyde Morris Blvd, Suite C, Ormond Beach, FL 32174-5956 | 2006-05-30 |
| 1033160981 | Kristen Noel Barnekov Rulka | Physician Assistant | 300 Clyde Morris Blvd, Suite C, Ormond Beach, FL 32174-5956 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215574991 | Case Vision Pa | Optometrist | Eye Savers, 1474 W. Granada Blvd. #470, Ormond Beach, FL 32174 | 2019-12-02 |
| 1235797143 | Galia Leilani Medrano Ramirez | Dentist | 1274 W. Granada Blvd, Ormond Beach, FL 32174 | 2019-06-05 |
| 1295299220 | Jessica Johnson Hills | Nurse Practitioner | 1400 Hand Ave Ste K, Ormond Beach, FL 32174 | 2019-01-23 |
| 1437507043 | Natasha Jairam | Family Medicine | Adventhealth Medical Group Family Medicine, 400 Clyde Morris Blvd Ste A, Ormond Beach, FL 32174 | 2016-05-25 |
| 1871956540 | Lisa Anne Parissi | Chiropractor | 157 Kimberly Drive, Ormond Beach, FL 32174 | 2016-03-31 |
| 1023477940 | Ambassador Health Services, Inc | In Home Supportive Care | 136 N Orchard St Ste 1, Ormond Beach, FL 32174 | 2016-02-19 |
| 1619341518 | Maria Rogers | Optometrist | 9 Abacus Ave, Ormond Beach, FL 32174 | 2015-11-16 |
| 1285003830 | Sydney Kalin Neuhardt | Nurse Practitioner | 725 W. Granada Blvd. Ste 1, Ormond Beach, FL 32174 | 2015-09-24 |
| 1194107821 | Jerusha Thacker | Case Manager/Care Coordinator | 259 Bill France Blvd. Ste 200, Daytona Beach, FL 32174 | 2015-06-18 |
| 1730569971 | Daniel Joseph Lapolla | Physical Therapy Assistant | 1275 Granada Blvd, Suite 4b2, Ormond Beach, FL 32174 | 2015-06-03 |
| Find all providers in zip 32174 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093378416 | Angelica Ray Kraus | Physician Assistant | 128 Lynwood Ln, Ormond Beach, FL 32174-4229 | 2019-04-22 |
| 1548443518 | Erika Leigh Jacumin | Physician Assistant | 8 Mirror Lake Dr., Ormond Beach, FL 32174 | 2007-12-12 |
| 1437206711 | Matthew Henry Hoffman | Physician Assistant | 775 W Granada Blvd Ste 102, Ormond Beach, FL 32174-5109 | 2007-01-05 |
| 1568543379 | Cheryl Kimmel | Physician Assistant | 77 W Granada Blvd, Ormond Beach, FL 32174-6302 | 2006-10-18 |
| 1427143809 | Michelle B Johnston | Physician Assistant | 335 Clyde Morris Blvd Ste 290, Ormond Beach, FL 32174-3196 | 2006-10-03 |
| 1144299124 | Angel I Ribo | Physician Assistant | 305 Clyde Morris Blvd Ste 220, Ormond Beach, FL 32174-8187 | 2006-03-14 |
| 1952911299 | Jennifer Michelle Anderson | Physician Assistant | 77 W Granada Blvd, Ormond Beach, FL 32174-6302 | 2020-08-02 |
| 1831711464 | Nicole Carman | Physician Assistant | 1400 Hand Ave Ste K, Ormond Beach, FL 32174-8195 | 2020-05-18 |
| 1265073894 | Francisco Thor Fiol | Physician Assistant | 8 Mirror Lake Dr, Ormond Beach, FL 32174-3101 | 2019-10-04 |
| 1336792597 | Rachel Roxanne Sullivan | Physician Assistant | 298 S Yonge St, Ormond Beach, FL 32174-6264 | 2019-07-17 |
| Find all providers in ORMOND BEACH | ||||
| City | ORMOND BEACH |
| Zip Code | 32174 |
Please comment or provide details below to improve the information on MR. KENNETH M. 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.