MR. STANLEY L. ROBERTS (NPI# 1922047414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922047414 |
| Entity Type | Individual |
| Full Name | MR. STANLEY L. ROBERTS |
| Credential | P.A.-C. |
| Practice Address |
510 Melton Hill Dr Clinton TN 37716-7107 |
| Practice Telephone | 8654574027 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2013-05-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA00015 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | MR0575754 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS | 4069076 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972509107 | Stanley K Roberts | Family Medicine | 6914 Nottingham Ln, Bettendorf, IA 52722-9705 | 2005-06-22 |
| 1891285284 | Stanley Lewis Roberts | Social Worker | 7162 Reading Rd Ste 900, Cincinnati, OH 45237-3879 | 2018-05-11 |
| 1124058961 | Stanley Alan Roberts | Dentist | 10 Kirtland St, Lynn, MA 01905-1821 | 2006-07-04 |
| 1316993520 | Stanley Dwayne Roberts | Emergency Medicine | 118 N Main St, Ste B, Salem, UT 84653-5698 | 2006-05-26 |
| Street Address |
510 MELTON HILL DR |
| City | CLINTON |
| State | TN |
| Zip Code | 37716-7107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730650870 | Kellye Watkins Wilson | Dental Hygienist | 420 S. Charles Seivers Blvd, Clinton, TN 37716 | 2018-12-16 |
| 1326428087 | Sandra Ella Humphrey Mincey | Registered Nurse | Mcneeley Family Physicians, 110 Executive Park Drive, Clinton, TN 37716 | 2015-06-08 |
| 1598157224 | Susan Price Teffeteller | Nurse Practitioner | 159 Frank L Diggs Road, Clinton, TN 37716 | 2015-03-04 |
| 1710268065 | Jimmy Neil Mcbride | Pharmacist | 1130 North Charles G. Seivers Boulevard, Clinton Drug Store, Clinton, TN 37716 | 2011-08-31 |
| 1265684658 | K-va-t Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 507 South Charles Sevier Boulevard, Clinton, TN 37716 | 2008-10-16 |
| 1912186016 | Comprehensive Industrial Services Inc | Physical Therapist | 1107 Charles Seivers Blvd, Suite 2, Clinton, TN 37716 | 2007-10-25 |
| 1205039120 | Pamela H. Gross, Ph.d, P.C. | Psychologist | 1729 Dutch Valley Road, Clinton, TN 37716 | 2007-06-07 |
| 1396872057 | Health Care Inc | Pharmacy | 1130 N Charles Seivers Blvd, Clinton, TN 37716 | 2007-02-28 |
| 1346389889 | Kellie Gaetz | Physical Therapist | 1115 Charles Seivers Blvd, Suite 22, Clinton, TN 37716 | 2007-02-05 |
| 1396883955 | Phoenix Counseling Services, Inc. | Counselor | 729 Charles Seivers, Clinton, TN 37716 | 2007-02-02 |
| Find all providers in zip 37716 | ||||
| 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 |
|---|---|---|---|---|
| 1700419041 | Alexander Sorokin Flecker | Physician Assistant | 200b Eager St, Clinton, MS 39056-4545 | 2020-02-14 |
| 1477190668 | Kimberly Mcraney Watson | Physician Assistant | 907 Oakhill Cir, Clinton, MS 39056-3743 | 2019-12-06 |
| 1649630229 | Elizabeth Atuya | Physician Assistant | 9135 Piscataway Rd Ste 102, Clinton, MD 20735-2548 | 2016-02-25 |
| 1780994376 | Karika Partilia Watkins-hill | Physician Assistant | 1515 Sunset Ave, Clinton, NC 28328-3827 | 2010-10-15 |
| 1184860827 | George L Carter | Physician Assistant | 10215 Deep Creek Ct, Clinton, MD 20735-5833 | 2008-12-31 |
| 1356471767 | Ann Rebecca Bartholomew | Physician Assistant | 1407 N 2000 W Ste G, Clinton, UT 84015-8563 | 2007-03-06 |
| 1598827172 | Akosua Flora Amankwah Wright | Physician Assistant | 7501 Surratts Rd Ste 303, Clinton, MD 20735-3377 | 2006-12-13 |
| 1356447882 | Mark Goodrich | Physician Assistant | 1477 North 2000 West, Westside Medical, Clinton, UT 84015 | 2006-09-15 |
| 1467556787 | Melanie Decock Wilson | Physician Assistant | 2900 S 25th St Ste B2, Clinton, IA 52732-7250 | 2006-09-08 |
| 1740206630 | Kolleen Marchand | Physician Assistant | 1477 N 2000 W, Clinton, UT 84015-8638 | 2006-07-14 |
| Find all providers in CLINTON | ||||
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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.