Individual provider Active NPI

Robert Edward Gates Jr., L.AC, AP

  • Acupuncturist
  • Oviedo, FL
National Provider Identifier
1073824371
Registry record updated Apr 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
673-055 Issued in WI
Practice address
2040 Winter Springs Blvd
Oviedo, FL 32765-9347
Phone
(407) 852-8584
NPI assigned
Jul 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 673-055 WI Primary
Acupuncturist 171100000X AP2809 FL

Addresses

Primary practice location

2040 Winter Springs Blvd
Oviedo, FL 32765-9347

Mailing address

1103 Ermine Ave
Winter Springs, FL 32708-4131
Phone (407) 852-8584

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP2809FLMDAcupuncturist
673-055WIMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302825600000",
    "number": "1073824371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 ERMINE AVE",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327084131",
            "telephone_number": "407-852-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 WINTER SPRINGS BLVD",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327659347",
            "telephone_number": "407-852-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "L.AC, AP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2011-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "673-055",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP2809",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.