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R. SHANE ROBERTS, M.D., INC.
NPI 1508062977
Family Medicine in Decatur, TN

Active since June 22, 2007CLIA 44D0915075 · Waiver
398 N MAIN ST, DECATUR, TN 37322(423) 334-2222(423) 334-2255 Get Directions Write a Review

NPPES record last updated: March 10, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 10, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About R. Shane Roberts, M.d., Inc. NPPES

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

R. SHANE ROBERTS, M.D., INC. (NPI 1508062977) is a healthcare organization registered as a family medicine in Decatur, Tennessee and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through May 16, 2028 and lists R. Shane Roberts, Owner, as its authorized official.

NPPES Registry Identity

NPI1508062977
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameR. SHANE ROBERTS, M.D., INC.
Location Address398 N MAIN STDecatur, TN 37322-7759
Mailing Address398 N Main StDecatur, TN 37322-7759 · (423) 334-2222 · Fax (423) 334-2255
Phone(423) 334-2222
Fax(423) 334-2255
Organization SubpartNo
Authorized OfficialR. Shane RobertsOwner · (423) 334-2222
Enumeration DateJune 22, 2007
Last NPPES UpdateMarch 10, 20222 updates tracked since enumeration
NPPES CertifiedMarch 10, 2022
✔ NPI 1508062977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TN · 024022
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
398 N MAIN ST, Decatur, TN 37322
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Other Identifiers 2

Medicaid3718733TN
Medicaid0443935TN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D0915075

R Shane Roberts MD Inc · Decatur, TN
Active · expires May 16, 2028
CLIA Number44D0915075
Laboratory TypePhysician Office
Certificate Effective DateMay 17, 2026
Certificate Expiration DateMay 16, 2028
Laboratory DirectorRodney S. Roberts MD
Laboratory Phone(423) 334-2222
Laboratory LocationR Shane Roberts MD Inc398 North Main Street, Decatur, TN 37322
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TONIA MICHELLE SCHUMAN FNP-C
Nurse Practitioner (Family)
398 N MAIN ST
DECATUR, TN 37322
Meigs County (423) 334-2222
RODNEY SHANE ROBERTS MD
Family Medicine
398 N MAIN ST
DECATUR, TN 37322
Meigs County (423) 334-2222
R. SHANE ROBERTS, M.D., INC.
Family Medicine
398 N MAIN ST
DECATUR, TN 37322
Meigs County (423) 334-2222

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is R. Shane Roberts, M.D., Inc.'s NPI number?

The NPI number for R. Shane Roberts, M.D., Inc. is 1508062977. It was assigned to this organization in the NPPES registry on June 22, 2007.

Where is R. Shane Roberts, M.D., Inc. located?

R. Shane Roberts, M.D., Inc. is located at 398 N Main St, Decatur, TN 37322. The listed phone number is (423) 334-2222.

What is R. Shane Roberts, M.D., Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does R. Shane Roberts, M.D., Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0915075) is associated with this NPI, valid through May 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for R. Shane Roberts, M.D., Inc. was last updated on March 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.