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J. GREGORY ROBERTS MD RVT NPI 1356486252


NPI Information

NPI: 1356486252
Provider Name: J. GREGORY ROBERTS MD RVT

Doing Business As: MANTLE CLINIC III

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
10810 PARKSIDE DR
SUITE 309
KNOXVILLE, TN
ZIP 37934
Phone: (865) 218-6244
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J. GREGORY ROBERTS MD RVT is a specialist in Knoxville, TN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. J. GREGORY ROBERTS MD RVT NPI is 1356486252. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mantle Clinic Iii.

The provider's business location address is:

10810 PARKSIDE DR
SUITE 309
KNOXVILLE, TN
ZIP 37934-979
Phone: (865) 218-6244
Fax: (865) 218-6245

The provider's authorized official is James Gregory Roberts .
The authorized official title is Physician and has the following contact phone number (865) 218-6244.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 5/21/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist37706TENNESSEEYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
164078132OTHERKENTUCKYKENTUCKY MEDICAID
24069830OTHERTENNESSEEBCBS
3$$$$$$$$$OTHERTENNESSEESOCIAL SECURITY NUMBER
4DA9327OTHERTENNESSEERAILROAD MEDICARE

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.