Active NPI
Richard Cleavelin Probert, MD
- Pediatrics Physician
- Evansville, IN
National Provider Identifier
1144282377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01036002
- Practice address
- 25 W Division St
Suite 400 West
Evansville, IN 47710-1374 - Phone
- (812) 436-4501
- Fax
- (812) 436-4510
- NPI assigned
- Apr 4, 2006
- Last updated
- Jan 6, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01036002 | IN | Primary |
Addresses
Primary practice location
25 W Division St
Suite 400 West
Evansville, IN 47710-1374
Mailing address
315 Mulberry St
Evansville, IN 47713-1252
Phone (812) 421-7489
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000806881 | Other | IN | ANTHEM BCBS |
| 100248000A | Medicaid | IN | |
| 200079040D | Other | IN | MEDICAID GROUP |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rprobert32352@direct.deaconess.com | Direct |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01036002 | IN | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1144282377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 MULBERRY ST",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131252",
"telephone_number": "812-421-7489",
"fax_number": "812-436-0209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 W DIVISION ST",
"address_2": "SUITE 400 WEST",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477101374",
"telephone_number": "812-436-4501",
"fax_number": "812-436-4510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROBERT",
"first_name": "RICHARD",
"middle_name": "CLEAVELIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-04",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01036002",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000806881",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100248000A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP",
"identifier": "200079040D",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rprobert32352@direct.deaconess.com",
"affiliation": "N",
"endpointDescription": "ECHO Community Healthcare, Inc.",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "25 W Division St",
"address_2": "Suite 400 West",
"city": "Evansville",
"state": "IN",
"country_code": "US",
"postal_code": "477101374",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Evansville, IN
- Jessica M Prifogle, PMHNP
- Primary Community Care Services, Inc.
- Primary Physicians Network LLC
- Sally G Primus, MD
- Lindsey Jo Pritchett, PHARMD
- Procare Healthspot, LLC (ProCare HealthSpot, LLC - Lynch)
- Procare Healthspot, LLC (ProCare HealthSpot, LLC - Vectren)
- Procare Healthspot, LLC
- Procare Healthspot, LLC
- Professional Eye Care of Evansville
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.