Individual provider Active NPI

Robert Edgar Sonneborn, MD

  • Internal Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1033189337
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME24573 Issued in FL
Practice address
1905 Clint Moore Rd
Suite 201
Boca Raton, FL 33496-2658
Phone
(561) 994-5454
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME24573 FL Primary
Nephrology Physician 207RN0300X ME24573 FL

Addresses

Primary practice location

1905 Clint Moore Rd
Suite 201
Boca Raton, FL 33496-2658

Mailing address

1905 Clint Moore Rd
Suite 201
Boca Raton, FL 33496-2658
Phone (561) 994-5454

Other identifiers 2

IdentifierTypeStateIssuer
P00413516OtherRAILROAD MEDICARE
71942OtherFLBCBS OF FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0029392FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1033189337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE RD",
            "address_2": "SUITE 201",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962658",
            "telephone_number": "561-994-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE RD",
            "address_2": "SUITE 201",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962658",
            "telephone_number": "561-994-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONNEBORN",
        "first_name": "ROBERT",
        "middle_name": "EDGAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME24573",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME24573",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00413516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "71942",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.