Active NPI
Eliza Robertson, MD
- Neurology Physician
- Lexington, KY
National Provider Identifier
1184771982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 43679
- Practice address
- 1221 S Broadway
Lexington, KY 40504-2701 - Phone
- (859) 258-4800
- Fax
- (859) 258-4740
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 43679 | KY | Primary |
Addresses
Primary practice location
1221 S Broadway
Lexington, KY 40504-2701
Mailing address
1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100124070 | Medicaid | KY |
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 |
|---|---|---|---|
| 43679 | KY | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613952000000",
"number": "1184771982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 S BROADWAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405042701",
"telephone_number": "859-258-4800",
"fax_number": "859-258-4740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 S BROADWAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405042701",
"telephone_number": "859-258-4800",
"fax_number": "859-258-4740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "ELIZA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2021-02-22",
"certification_date": "2021-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "KY",
"license": "43679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100124070",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.