JENNIFER ROBERTS PA-C NPI 1497902944

NPI Information

NPI: 1497902944
Provider Name: JENNIFER ROBERTS, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
3533 SOUTHERN BLVD STE 5650
KETTERING, OH
ZIP 45429
Phone: (937) 294-3611
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Jennifer Roberts, PA-C is a surgical physician assistant in Kettering, OH with 9 years of experience. Jennifer Roberts, PA-C NPI is 1497902944. 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:

3533 SOUTHERN BLVD STE 5650
KETTERING, OH
ZIP 45429-263
Phone: (937) 294-3611
Fax: (937) 294-9010

The NPI 1497902944 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 8/26/2008 and was last updated on 12/17/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	50.002811	OHIO	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	0743039	MEDICAID	OHIO

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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