Individual provider Active NPI

Robyn Fae Harbaugh, LPN

  • Licensed Practical Nurse
  • Buchanan, MI
National Provider Identifier
1124413091
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703093643 Issued in MI
Practice address
15931 Walnut St
Buchanan, MI 49107-9273
Phone
(269) 409-8333
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 47039242A IN
Licensed Practical Nurse 164W00000X 4703093643 MI Primary

Addresses

Primary practice location

15931 Walnut St
Buchanan, MI 49107-9273

Mailing address

15931 Walnut St
Buchanan, MI 49107-9273
Phone (269) 409-8333

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
47039242AINMDLicensed Practical Nurse
4703093643MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1124413091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15931 WALNUT ST",
            "city": "BUCHANAN",
            "state": "MI",
            "postal_code": "491079273",
            "telephone_number": "269-409-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15931 WALNUT ST",
            "city": "BUCHANAN",
            "state": "MI",
            "postal_code": "491079273",
            "telephone_number": "269-409-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBAUGH",
        "first_name": "ROBYN",
        "middle_name": "FAE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IN",
            "license": "47039242A",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703093643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buchanan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.