Individual provider Active NPI

Jana Robertson, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1184836181
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P3428 Issued in TX
Practice address
12461 Timberland Blvd
Suite 309
Fort Worth, TX 76244-5213
Phone
(817) 741-5437
Fax
(888) 400-5412
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P3428 TX Primary

Addresses

Primary practice location

12461 Timberland Blvd
Suite 309
Fort Worth, TX 76244-5213

Mailing address

12461 Timberland Blvd
Suite 309
Fort Worth, TX 76244-5213
Phone (817) 741-5437

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P3428TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Primary Care Assoc PLLC Pediatrics Past 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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1184836181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12461 TIMBERLAND BLVD",
            "address_2": "SUITE 309",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445213",
            "telephone_number": "817-741-5437",
            "fax_number": "888-400-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12461 TIMBERLAND BLVD",
            "address_2": "SUITE 309",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445213",
            "telephone_number": "817-741-5437",
            "fax_number": "888-400-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P3428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; 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.