DR. KATHLEEN ANNE ROBERTS DNP NPI 1053307090

NPI Information

NPI: 1053307090
Provider Name: DR. KATHLEEN ANNE ROBERTS, DNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2725 SW CEDAR HILLS BLVD STE 200
BEAVERTON, OR
ZIP 97005
Phone: (503) 352-6000
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DR. Kathleen Anne Roberts, DNP is a family nurse practitioner in Beaverton, OR with 14 years of experience. DR. Kathleen Anne Roberts, DNP NPI is 1053307090. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2725 SW CEDAR HILLS BLVD STE 200
BEAVERTON, OR
ZIP 97005-435
Phone: (503) 352-6000
Fax: (503) 352-6081

The NPI 1053307090 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/26/2005 and was last updated on 1/9/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	95193472	CALIFORNIA	No
2	363LF0000X	Nurse Practitioner	Family	5173	TENNESSEE	No
3	363LF0000X	Nurse Practitioner	Family	CNP211353	MAINE	No
4	363LF0000X	Nurse Practitioner	Family	AP60728469	WASHINGTON	No
5	363LF0000X	Nurse Practitioner	Family	201708253	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3903423	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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