Individual provider Active NPI

Robert T Bobo, M.D.

  • Orthopaedic Surgery Physician
  • Collierville, TN
National Provider Identifier
1043200611
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
8887 Issued in TN
Practice address
511 Market Blvd Ste 103
Collierville, TN 38017-2360
Phone
(901) 850-1150
NPI assigned
Oct 25, 2005
Last updated
Apr 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 8887 TN Primary

Addresses

Primary practice location

511 Market Blvd Ste 103
Collierville, TN 38017-2360

Mailing address

511 Market Blvd Ste 103
Collierville, TN 38017-2360
Phone (901) 850-1150

Other identifiers 1

IdentifierTypeStateIssuer
3173033MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100726000081 TN Practitioner - Orthopedic Surgery 6305987165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Mississippi School of Medicine, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Orthopaedics and Sports Medicine, PLLCGroup PAC ID 4486810314, 3 clinicians

Practice addresses (Care Compare)

511 Market Blvd
Suite 103
Collierville, TN 38017-2360
Phone (901) 850-1150

Merit-based Incentive Payment System (MIPS)

Final score
79.93 of 100Reported as group
Quality
78.08
Promoting interoperability
74
Improvement activities
40
Cost
76.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8887TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Orthopaedics & Sports Medicine, PLLC Orthopaedic Surgery CurrentSince Jan 1, 2021 Accepting new patients

Locations

1500 W Poplar Ave
Ste 301
Collierville, TN 38017
Phone (901) 759-5503

472 W Poplar Ave
Ste 200
Collierville, TN 38017
Phone (901) 850-1150

511 Market Blvd
Ste 103
Collierville, TN 38017
Phone (901) 850-1150

Interoperability endpoints

  • Direct secure messaging: robert.bobo.1@18248.direct.athenahealth.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1043200611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MARKET BLVD STE 103",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172360",
            "telephone_number": "901-850-1150",
            "fax_number": "901-850-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MARKET BLVD STE 103",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172360",
            "telephone_number": "901-850-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBO",
        "first_name": "ROBERT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "8887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3173033",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

Verify at the official NPI Registry.