Individual provider Active NPI

Robert Thomas Alexander, ACNP-BC, FNP-BC

  • Family Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1073817896
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP10014 Issued in AZ
Practice address
2730 S Val Vista Dr
Suite 188
Gilbert, AZ 85295-1675
Phone
(480) 299-0589
Fax
(602) 391-2757
NPI assigned
Jan 8, 2011
Last updated
Apr 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP3870 AZ
Family Nurse Practitioner 363LF0000X AP10014 AZ Primary

Addresses

Primary practice location

2730 S Val Vista Dr
Suite 188
Gilbert, AZ 85295-1675

Mailing address

21911 E Escalante Rd
Queen Creek, AZ 85142-4589
Phone (602) 524-8193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120507000577 AZ Practitioner - Nurse Practitioner 0941462014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP3870AZMDAcute Care Nurse Practitioner
AP10014AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander Medical LLC Past Accepting new patients
Afc Physical Medicine of Gilbert, PLLC Past Accepting new patients
Adult & Childrens Chiropractix, PC PastSince May 19, 2017 Accepting new patients

Organizations & group practices 4

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": "1294444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1073817896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21911 E ESCALANTE RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424589",
            "telephone_number": "602-524-8193",
            "fax_number": "602-391-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR",
            "address_2": "SUITE 188",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951675",
            "telephone_number": "480-299-0589",
            "fax_number": "602-391-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "ROBERT",
        "middle_name": "THOMAS",
        "credential": "ACNP-BC, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-08",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP3870",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.