Active NPI
Wilton Edward Robinson Jr., MD
- Student in an Organized Health Care Education/Training Program
- Philadelphia, PA
National Provider Identifier
1184202079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- MT226196
- Practice address
- 3401 N Broad St
Philadelphia, PA 19140-5103 - Phone
- (215) 707-7022
- NPI assigned
- Mar 31, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | MT226196 | PA | Primary |
Addresses
Primary practice location
3401 N Broad St
Philadelphia, PA 19140-5103
Mailing address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-7022
Other practice location 1
720 Westview Dr SW
Atlanta, GA 30310-1458
Phone (404) 756-1383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250724002107 | GA | Order and Referring Only - Pain Management | 6204217920 |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2727 Paces Ferry Rd SE
Suite 1 1100
Atlanta, GA 30339-6151
PO Box
Atlanta, GA 30368
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13536 | GA | MD | Pharmacist |
| MT226196 | PA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1184202079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405103",
"telephone_number": "215-707-7022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405103",
"telephone_number": "215-707-7022"
}
],
"practiceLocations": [
{
"address_1": "720 Westview Dr SW",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303101458",
"country_code": "US",
"telephone_number": "404-756-1383",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBINSON",
"first_name": "WILTON",
"middle_name": "EDWARD",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-31",
"last_updated": "2022-06-28",
"certification_date": "2022-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "MT226196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.