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DR. JOHN BOONE ROBERSON SR.
NPI 1871607812
Dentist - Oral and Maxillofacial Surgery in Hattiesburg, MS

Active since August 18, 2006PECOS Enrolled
811 SOUTH 28TH AVENUE, HATTIESBURG, MS 39402(601) 261-2611(601) 261-2711 Get Directions Write a Review

NPPES record last updated: March 7, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. John Boone Roberson Sr. NPPES

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

DR. JOHN BOONE ROBERSON SR. (NPI 1871607812) is an individual oral and maxillofacial surgery provider in Hattiesburg, Mississippi, licensed in Mississippi (274693) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871607812
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. JOHN BOONE ROBERSON SR.
Location Address811 SOUTH 28TH AVENUEHattiesburg, MS 39402
Mailing Address811 South 28th AvenueHattiesburg, MS 39402 · (601) 261-2611 · Fax (601) 261-2711
Phone(601) 261-2611
Fax(601) 261-2711
Sole ProprietorNo
Enumeration DateAugust 18, 2006
Last NPPES UpdateMarch 7, 2012
✔ NPI 1871607812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in MS · 274693
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
811 SOUTH 28TH AVENUE, Hattiesburg, MS 39402
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Other Identifiers 2

Medicaid00660451MS
Medicaid01951327MS

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. John Boone Roberson Sr. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39402 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$64.96 typical visit price
range $16.15 – $129.61
Typical copayment $16.24 (range $4.03 – $32.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 John Roberson's NPI number?

The NPI number for John Roberson is 1871607812. It was assigned to this individual provider in the NPPES registry on August 18, 2006.

Where is John Roberson located?

John Roberson practices at 811 South 28th Avenue, Hattiesburg, MS 39402. The listed phone number is (601) 261-2611.

What is John Roberson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is John Roberson enrolled in Medicare?

Yes. John Roberson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for John Roberson was last updated on March 7, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.