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J. GREGORY ROBERTS MD RVT PC DBA MANTLE CLINIC III NPI 1609075464


NPI Information

NPI: 1609075464
Provider Name: J. GREGORY ROBERTS, MD, RVT, PC DBA MANTLE CLINIC III
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
10810 PARKSIDE DR STE 309
KNOXVILLE, TN
ZIP 37934
Phone: (865) 218-6244
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J. GREGORY ROBERTS, MD, RVT, PC DBA MANTLE CLINIC III 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, PC DBA MANTLE CLINIC III NPI is 1609075464. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10810 PARKSIDE DR STE 309
KNOXVILLE, TN
ZIP 37934-986
Phone: (865) 218-6244
Fax: (865) 218-6245

The provider's authorized official is Barbara Ann Freels .
The authorized official title is Practice Manager and has the following contact phone number (865) 218-6244.

The enumeration date for this NPI number is 7/12/2007 and was last updated on 11/16/2010.


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
1TN0101OTHERTENNESSEEJOHN DEERE HEALTH
23723399MEDICARE PINTENNESSEE
364078132MEDICAIDKENTUCKY
4=========MEDICAIDTENNESSEE
54069830OTHERBCBS

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.