Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1174517262 Deactivated / Inactive NPI Male Practitioner

Dr. John Manley Roberts , MD

Specialist • Bangor, ME

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Roberts has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 06, 2005
NPI Deactivation Date October 05, 2020
Total Practice Duration ~15 Years of Practice (2005 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. John Roberts, MD was a registered Specialist practicing in Bangor, ME. Throughout an active medical career spanning 15 years, Dr. Roberts provided care at the practice location at 404 STATE ST until profile deactivation on 2020-10-05.

Practice Location & Contact Primary Location

Practice Address

404 State St

Bangor, ME 044016623

Telephone 2079453496
Fax 2079455027
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Bangor, ME

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 33.4 Yrs
State Avg: 33.1 Yrs
Regional Practice Density
34 Specialists

Practicing in Bangor, ME (267 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License ME 013468

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1861486052

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated October 05, 2020

Record deactivated on October 05, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 404 STATE ST, BANGOR, ME 044016623 (Tel: 2079453496)

📍
Updated Business Mailing Address July 08, 2007

Registered at 404 STATE ST, BANGOR, ME 044016623 (Tel: 2079453496)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN ROBERTS, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #013468 in ME)

🟢
Initial NPI Registration & Enumeration September 06, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. John Roberts. Be the first to share your experience!

Sign in to leave a review for Dr. John Roberts

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1174517262
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 06, 2005
Last Update: July 08, 2007
Deactivation Date: October 05, 2020

Mailing Address

404 State St

Bangor, ME 044016623

Phone: 2079453496

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.