Organization Active NPI

Robert J Jantz

  • Family Medicine Physician
  • Lebanon, TN
National Provider Identifier
1104096288
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD18858 Issued in TN
Legal business name
ROBERT J JANTZ
Practice address
706 Cadet CT
Lebanon, TN 37087-2649
Phone
(615) 449-2472
Fax
(615) 449-4709
NPI assigned
Mar 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Dr. Robert Joseph Jantz, MDNPI 1396751749
Title
Owner
Phone
(615) 449-2472

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD18858 TN Primary

Addresses

Primary practice location

706 Cadet CT
Lebanon, TN 37087-2649

Mailing address

706 Cadet CT
Lebanon, TN 37087-2649
Phone (615) 449-2472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050506000591 TN Part B Supplier - Clinic/Group Practice 4688614803 Receives reassigned benefits from 4 practitioners
Practice locations: Lebanon, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0875854Robert J Jantz MD706 Cadet Court, Lebanon, TN 37087Provider-performed microscopyJul 31, 2026

National Provider Directory

National Provider Directory

Locations

202 S College St
Lebanon, TN 37087

706 Cadet Ct
Lebanon, TN 37087
Phone (615) 206-9111

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1104096288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 CADET CT",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872649",
            "telephone_number": "615-449-2472",
            "fax_number": "615-449-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 CADET CT",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872649",
            "telephone_number": "615-449-2472",
            "fax_number": "615-449-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J JANTZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "JANTZ",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-449-2472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD18858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.