Individual provider Active NPI

Robyn Hitchcock, MD

  • Emergency Medicine Physician
  • Florence, OR
National Provider Identifier
1003038803
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD202055 Issued in OR
Practice address
400 9TH St
Florence, OR 97439-7398
Phone
(541) 997-8412
Fax
(541) 902-1695
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD60865850 WA
Emergency Medicine Physician 207P00000X 2019-00092 NC
Emergency Medicine Physician 207P00000X 63707 MN
Emergency Medicine Physician 207P00000X MD2019-0471 NM
Emergency Medicine Physician 207P00000X 59931 AZ
Emergency Medicine Physician 207P00000X M-9382 ID
Emergency Medicine Physician 207P00000X MD202055 OR Primary

Addresses

Primary practice location

400 9TH St
Florence, OR 97439-7398

Mailing address

1115 SE 164TH Ave Dept 358
Vancouver, WA 98683-8004
Phone (360) 729-1253

Other practice location 1

801 E Wheeler Rd
Moses Lake, WA 98837-1820
Phone (509) 765-5606

Other practice location 2

11735 N. Eastshore Dr.
Hayden, ID 83835
Phone (208) 209-3298

Other identifiers 1

IdentifierTypeStateIssuer
2006702MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090115000797 ID Practitioner - Emergency Medicine 5193888204 Reassigns benefits to 1 organization
I20210128002925 OR Practitioner - Emergency Medicine 5193888204 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2019-00092NCMDEmergency Medicine Physician
MD2019-0471NMMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shoshone Medical Center CurrentSince Jul 1, 2014 Accepting new patients
Good Shepherd Health Care System CurrentSince Jan 15, 2021 Accepting new patients
Shoshone Medical Center CurrentSince Jul 1, 2014 Accepting new patients
Kootenai Health, Inc. Past Accepting new patients
Kootenai Health, Inc. Emergency Medicine Past Accepting new patients

Locations

25 Jacobs Gulch Rd
Kellogg, ID 83837
Phone (208) 784-1221

610 NW 11th St
Hermiston, OR 97838
Phone (541) 667-3400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9a0a9763-cc6e-4ca0-bdec-c16291c965b9/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1003038803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "360-729-1253",
            "fax_number": "360-729-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 9TH ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974397398",
            "telephone_number": "541-997-8412",
            "fax_number": "541-902-1695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 E Wheeler Rd",
            "address_purpose": "LOCATION",
            "city": "Moses Lake",
            "state": "WA",
            "postal_code": "988371820",
            "country_code": "US",
            "telephone_number": "509-765-5606",
            "fax_number": "509-764-3244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11735 N. Eastshore Dr.",
            "address_purpose": "LOCATION",
            "city": "Hayden",
            "state": "ID",
            "postal_code": "83835",
            "country_code": "US",
            "telephone_number": "208-209-3298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HITCHCOCK",
        "first_name": "ROBYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60865850",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2019-00092",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "63707",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2019-0471",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "59931",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-9382",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD202055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2006702",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, OR

Sources for this page

Verify at the official NPI Registry.