Individual provider Active NPI

Robert Lawrence Munt Jr., MD

  • Pediatrics Physician
  • Raleigh, NC
National Provider Identifier
1063464485
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
21831 Issued in NC
Practice address
4414 Lake Boone Trail
Suite 103
Raleigh, NC 27607
Phone
(919) 787-0266
Fax
(919) 571-9314
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 21831 NC Primary

Addresses

Primary practice location

4414 Lake Boone Trail
Suite 103
Raleigh, NC 27607

Mailing address

4414 Lake Boone Trail
Suite 103
Raleigh, NC 27607
Phone (919) 787-0266

Other identifiers 2

IdentifierTypeStateIssuer
012U3OtherNCBCBS
79012U3MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20140311001095 NC Practitioner - Pediatric Medicine 3577793603 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21831NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
White Oak Pediatric Associates PA CurrentSince Jan 13, 2014 Accepting new patients
White Oak Pediatric Associates Pediatrics PastSince Jan 13, 2014 Accepting new patients

Locations

4414 Lake Boone Trl
Ste 103
Raleigh, NC 27607
Phone (919) 787-0266

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HICECA

Organizations & group practices 2

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1063464485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRAIL",
            "address_2": "SUITE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27607",
            "telephone_number": "919-787-0266",
            "fax_number": "919-571-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRAIL",
            "address_2": "SUITE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27607",
            "telephone_number": "919-787-0266",
            "fax_number": "919-571-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNT",
        "first_name": "ROBERT",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "21831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "012U3",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79012U3",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.