Individual provider Active NPI

Robert E Bell, D.O.

  • Family Medicine Physician
  • Lake City, FL
National Provider Identifier
1174597124
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46365 Issued in CO
Practice address
619 S Marion Ave
Lake City, FL 32025-5808
Phone
(386) 755-3016
Fax
(386) 719-3622
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 46365 CO Primary

Addresses

Primary practice location

619 S Marion Ave
Lake City, FL 32025-5808

Mailing address

619 S Marion Ave
Lake City, FL 32025-5808
Phone (386) 755-3016

Other identifiers 1

IdentifierTypeStateIssuer
67477542MedicaidCO

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46365COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Family Medical, PC Family Medicine PastSince May 1, 2008 Accepting new patients

Organizations & group practices 1

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1174597124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "386-755-3016",
            "fax_number": "386-719-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "386-755-3016",
            "fax_number": "386-719-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELL",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "46365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67477542",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.