Active NPI
Robin D Durrett, DO
- Surgery Physician
- Ellinwood, KS
National Provider Identifier
1053374710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 05-25299
- Practice address
- 611 N Main St
Ellinwood, KS 67526-1440 - Phone
- (620) 564-3771
- Fax
- (620) 564-2684
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 05-25299 | KS | Primary |
Addresses
Primary practice location
611 N Main St
Ellinwood, KS 67526-1440
Mailing address
611 N Main St
Ellinwood, KS 67526-1440
Phone (620) 564-3771
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-25299 | KS | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1053374710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 N MAIN ST",
"city": "ELLINWOOD",
"state": "KS",
"postal_code": "675261440",
"telephone_number": "620-564-3771",
"fax_number": "620-564-2684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 N MAIN ST",
"city": "ELLINWOOD",
"state": "KS",
"postal_code": "675261440",
"telephone_number": "620-564-3771",
"fax_number": "620-564-2684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURRETT",
"first_name": "ROBIN",
"middle_name": "D",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2021-03-17",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KS",
"license": "05-25299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellinwood, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.