CHESTER CARTER ROBERTS JR. PA-C
NPI 1154365690
Physician Assistant - Surgical in Poplar Bluff, MO

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

Active since June 15, 2006PECOS Enrolled

1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901(573) 778-4393(573) 778-4304 Get Directions Write a Review

NPPES record last updated: January 12, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Chester Carter Roberts Jr. Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHESTER CARTER ROBERTS JR. PA-C (NPI 1154365690) is an individual surgical provider in Poplar Bluff, Missouri, licensed in Missouri (2011037573) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154365690

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameCHESTER CARTER ROBERTS JR.Credential: PA-C

Location Address1500 N WESTWOOD BLVDPoplar Bluff, MO 63901-3318

Mailing Address1500 N Westwood BlvdPoplar Bluff, MO 63901-3318 · (573) 778-4393 · Fax (573) 778-4304

Phone(573) 778-4393

Fax(573) 778-4304

Sole ProprietorNo

Enumeration DateJune 15, 2006

Last NPPES UpdateJanuary 12, 2012

✔ NPI 1154365690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in MO · 2011037573

1500 N WESTWOOD BLVD, Poplar Bluff, MO 63901

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chester Carter Roberts Jr. Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.