Individual provider Active NPI

Daniel M Robertson, MD

  • Anesthesiology Physician
  • North Little Rock, AR
National Provider Identifier
1154414738
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R4157 Issued in AR
Practice address
5201 North Shore Drive
North Little Rock, AR 72118-5312
Phone
(501) 748-8000
Fax
(501) 748-8159
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R4157 AR Primary

Addresses

Primary practice location

5201 North Shore Drive
North Little Rock, AR 72118-5312

Mailing address

4 Shackleford Plaza
Suite 212
Little Rock, AR 72211-1844
Phone (501) 223-9991

Other identifiers 1

IdentifierTypeStateIssuer
54647OtherARAR BCBS

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

LicenseStateTypeSpecialty
R4157ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Anesthesia Consultants PLLC Anesthesiology Past Accepting new patients
Pinnacle Anesthesia Consultants, PLLC PastSince Apr 4, 2005 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154414738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SHACKLEFORD PLAZA",
            "address_2": "SUITE 212",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111844",
            "telephone_number": "501-223-9991",
            "fax_number": "501-223-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 NORTH SHORE DRIVE",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185312",
            "telephone_number": "501-748-8000",
            "fax_number": "501-748-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "DANIEL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "R4157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "54647",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.