Active NPI
Robert Cornelius Luten, M.D.
- Emergency Medicine Physician
- Jacksonville, FL
National Provider Identifier
1164493250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME34114
- Practice address
- 655 W 8TH St
Ufjp Emergency Medicine
Jacksonville, FL 32209-6511 - Phone
- (904) 244-7234
- Fax
- (904) 244-4508
- NPI assigned
- Jan 28, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | ME34114 | FL | Primary |
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | ME34114 | FL | |
| Pediatrics Physician | 208000000X | ME34114 | FL |
Addresses
Primary practice location
655 W 8TH St
Ufjp Emergency Medicine
Jacksonville, FL 32209-6511
Mailing address
PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0399078-00 | Medicaid | FL | |
| 000218908A | Medicaid | GA | |
| 930003868 | Other | FL | RAILROAD MEDICARE |
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 |
|---|---|---|---|
| ME34114 | FL | MD | Pediatrics Physician |
Interoperability endpoints
- rluten59403@direct.shands.ufl.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280188800000",
"number": "1164493250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44008",
"address_2": "UFJP PROVIDER ENROLLMENT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322314008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 W 8TH ST",
"address_2": "UFJP EMERGENCY MEDICINE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322096511",
"telephone_number": "904-244-7234",
"fax_number": "904-244-4508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTEN",
"first_name": "ROBERT",
"middle_name": "CORNELIUS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-28",
"last_updated": "2010-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME34114",
"primary": true
},
{
"code": "207PP0204X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Pediatric Emergency Medicine",
"state": "FL",
"license": "ME34114",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME34114",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0399078-00",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000218908A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "930003868",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.