Tyler Robertson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5914 Issued in WI

Practice address

1039 W Mason St
Green Bay, WI 54303-1842

Phone

(920) 965-7707

NPI assigned

Jan 11, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foundations Health and Wholeness Inc 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Foundations Health and Wholeness Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1497840607

  WI

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1194181891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 BAY VIEW DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031842",
            "telephone_number": "920-965-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "TYLER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce J. Robertson, PHD
• Cheryl M Robertson
• Mary E Robertson, APNP
• Savana Lorron Robertson
• Tara L Robertson, MS.,PSYD
• Bethany A Robinson, BA
• Brock Lyndsey Robinson, MD
• Charmin Robinson
• Christopher Michael Robinson, APRN, CRNA, DNAP
• Jordan Robinson, LAT, ATC

• All providers in Green Bay, WI
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.

Verify at the official NPI Registry.