Active NPI
Timothy Walter Robertson, RPH
- Pharmacist
- Glen Allen, VA
National Provider Identifier
1154328151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202010759
- Practice address
- 10250 Staples Mill Rd
Glen Allen, VA 23060-3064 - Phone
- (804) 591-4320
- NPI assigned
- Jul 5, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202010759 | VA | Primary |
Addresses
Primary practice location
10250 Staples Mill Rd
Glen Allen, VA 23060-3064
Mailing address
10601 Purcell Rd
Glen Allen, VA 23060-4436
Phone (804) 363-5114
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202010759 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614729600000",
"number": "1154328151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10601 PURCELL RD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230604436",
"telephone_number": "804-363-5114",
"fax_number": "804-261-5631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10250 STAPLES MILL RD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230603064",
"telephone_number": "804-591-4320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "TIMOTHY",
"middle_name": "WALTER",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2021-03-03",
"certification_date": "2021-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202010759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Allen, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.