JACQUELYN R. ROBERSON (NPI# 1982771358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982771358 |
| Entity Type | Individual |
| Full Name | JACQUELYN R. ROBERSON |
| Credential | M.D. |
| Practice Address |
Henry Ford Health System 2799 West Grand Boulevard Detroit MI 48202 |
| Practice Telephone | 3139162436 |
| Mailing Telephone | 3139162436 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
4301037509 | MI | Allopathic & Osteopathic Physicians |
| X | 208000000X | Pediatrics | 4301037509 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| COMMERCIAL-COMMERCIAL NUMBER | JR037509 | 01 | |
| CHAMPUS-CHAMPUS | JR037509 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331694 | Jacquelyn Ranae Roberson | Licensed Practical Nurse | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2019-05-15 |
| Street Address |
HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD |
| City | DETROIT |
| State | MI |
| Zip Code | 48202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336147461 | Joseph Lawrence Lelli | Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2005-07-12 |
| 1053794859 | Ali Malik | Podiatrist | Henry Ford Health System, 1 Ford Pl Ste 2e, Detroit, MI 48202 | 2015-06-30 |
| 1730389198 | Folusho Everton Ogunfiditimi | Physician Assistant | Henry Ford Health System, 2799 West Grand Blvd., Detroit, MI 48202 | 2007-07-23 |
| 1598897696 | Geoffrey S. Mwaungulu | Internal Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-03-12 |
| 1578606463 | Rebecca S. Lurcott | Ophthalmology | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-02-14 |
| 1184767949 | Jan Rival | Internal Medicine | Henry Ford Health System, 3031 West Grand Blvd., Detroit, MI 48202 | 2007-02-14 |
| 1295875342 | Vinaya Vallabhaneni | Preventive Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-02-07 |
| 1699821157 | Morton B. Cash | Radiology | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-01-26 |
| 1881748242 | Felix Umansky | Neurological Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-01-23 |
| 1558415901 | Sidney Goldstein | Internal Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699712174 | Gerald L. Feldman | Medical Genetics | 3950 Beaubien St Fl 3, Children's Hospital of Michigan, Detroit, MI 48201-2120 | 2006-06-01 |
| 1912944919 | Erawati Vishwas Bawle | Medical Genetics | 3901 Beaubien Blvd, Children's Hospital of Michigan, Div of Genetics., Detroit, MI 48201-2061 | 2006-05-31 |
| 1750732590 | Stephanie Campbell | Medical Genetics | 3901 Beaubien St, Detroit, MI 48201-2119 | 2016-06-22 |
| 1518157510 | Robert L Conway | Medical Genetics | 3950 Beaubien - 3rd Fl, Children's Hospital of Mi, Detroit, MI 48201 | 2007-07-26 |
| 1326250564 | Leigh Flore | Medical Genetics | 3901 Beaubien, Children's Hospital of Mi, Detroit, MI 48201 | 2007-05-03 |
| 1073680443 | Mary Helen Quigg | Medical Genetics | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2006-11-29 |
| 1861402497 | Vinod K Misra | Medical Genetics | 3950 Beaubien St, Detroit, MI 48201-2120 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568721850 | Timothy Moss | Medical Genetics | 25 Michigan St Ne Ste 2000, Grand Rapids, MI 49503-2526 | 2012-05-08 |
| 1679869143 | Stacie Diane Adams | Medical Genetics | 4660 S Hagadorn Rd Ste 405, East Lansing, MI 48823 | 2011-06-23 |
| 1497960397 | Allison Meredith Jay | Medical Genetics | 19229 Mack Ave Ste 18, Grosse Pointe Woods, MI 48236-2857 | 2007-05-14 |
| 1134133762 | Andrea Amalfitano | Medical Genetics | 1600 W Grand River Ste 2, Okemos, MI 48864 | 2006-07-28 |
| 1427411131 | Linda Zhong Rossetti | Medical Genetics | 25 Michigan St Ne Ste 2000, Grand Rapids, MI 49503-2526 | 2016-03-30 |
| 1609256064 | Elizabeth Grace Ames | Medical Genetics | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2015-06-01 |
| 1932519253 | Kristen Nicole Lee | Medical Genetics | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2014-05-08 |
| 1194067470 | Amanda Barone Pritchard | Medical Genetics | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2013-03-25 |
| 1184934291 | Spectrum Health Hospitals | Medical Genetics | 25 Michigan St Ne, Suite 2000, Grand Rapids, MI 49503-2515 | 2010-10-08 |
| 1124353727 | Michigan Spine and Brain Institute PC | Medical Genetics | 5400 Mackinaw Rd, Suite 2300, Saginaw, MI 48604-9515 | 2009-10-15 |
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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.