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NPI Code Detail

MEDICARE: RICK N. ROBERTS M.D.

MEDICARE: RICK N. ROBERTS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianM8183ID
2207Q00000XFamily Medicine PhysicianM-8183ID

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4110221065OTHERIDRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000010032233OTHERIDBLUE SHIELD
2806354700OTHERIDHEALTHY CONNOCTIONS
3000010032234OTHERIDBLUE SHIELD
541996OTHERIDBLUE CROSS
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558351551
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICK N. ROBERTS M.D.
Provider Business Mailing Address
First Line : PO BOX 191050
Second Line :
City : BOISE
State : ID
Zip : 83719-1050
Country : US
Telephone Number : 208-985-1423
Fax Number : 208-955-6501
Provider Business Practice Location Address
First Line : 1375 N HAPPY VALLEY RD
Second Line :
City : NAMPA
State : ID
Zip : 83687-5280
Country : US
Telephone Number : 208-809-2869
Fax Number : 208-809-2870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 04/24/2024

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