Active NPI
Sally Ann Robertson, ARNP, NP-C
- Nurse Practitioner
- Temple Terrace, FL
National Provider Identifier
1073033676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN9251941
- Practice address
- 12470 Telecom Dr Ste 300W
Temple Terrace, FL 33637-0904 - Phone
- (813) 871-8200
- Fax
- (813) 357-5501
- NPI assigned
- Jun 23, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | ARNP9251941 | FL | |
| Primary Care Nurse Practitioner | 363LP2300X | ARNP9251941 | FL | |
| Nurse Practitioner | 363L00000X | APRN9251941 | FL | Primary |
Addresses
Primary practice location
12470 Telecom Dr Ste 300W
Temple Terrace, FL 33637-0904
Mailing address
12470 Telecom Dr Ste 300W
Temple Terrace, FL 33637-0904
Phone (813) 871-8200
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN9251941 | FL | MD | Nurse Practitioner |
| ARNP9251941 | FL | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bond Urgent Care LLC | Past | Accepting new patients |
Interoperability endpoints
- sally.robertson.p1@direct.bondclinicpa.nextgenshare.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 and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Winter Haven, FL
- NPI 1235641739
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1073033676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12470 TELECOM DR STE 300W",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336370904",
"telephone_number": "813-871-8200",
"fax_number": "813-357-5501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12470 TELECOM DR STE 300W",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336370904",
"telephone_number": "813-871-8200",
"fax_number": "813-357-5501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "SALLY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "ARNP, NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-23",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "ARNP9251941",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "FL",
"license": "ARNP9251941",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "APRN9251941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Temple Terrace, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.