Organization Active NPI

Robertson & Koenig LTD

Doing business as Dr Carl D Robertson and Dr Gregory S Koenig Optometrists

  • Optometrist
  • Fallon, NV
National Provider Identifier
1194798231
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ROBERTSON & KOENIG LTD
Doing business as
Dr Carl D Robertson and Dr Gregory S Koenig Optometrists
Practice address
65 N Taylor St
Fallon, NV 89406-2750
Phone
(775) 423-8024
Fax
(775) 423-8593
NPI assigned
Feb 9, 2006
Last updated
Apr 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Dr. Carl D Robertson, OD
Title
President
Phone
(775) 423-8024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

65 N Taylor St
Fallon, NV 89406-2750

Mailing address

65 N Taylor St
Fallon, NV 89406-2750
Phone (775) 423-8024

Other identifiers 1

IdentifierTypeStateIssuer
100506217MedicaidNV

Other names 1

  • Dr Carl D Robertson and Dr Gregory S Koenig Optometrists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324000939 NV Part B Supplier - Clinic/Group Practice 5193616480 Receives reassigned benefits from 5 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yerington, NV; Fernley, NV; Dayton, NV; Fallon, NV

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

6 Pine Cone Rd
Ste 6
Dayton, NV 89403
Phone (775) 285-7573

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1194798231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N TAYLOR ST",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894062750",
            "telephone_number": "775-423-8024",
            "fax_number": "775-423-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N TAYLOR ST",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894062750",
            "telephone_number": "775-423-8024",
            "fax_number": "775-423-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTSON & KOENIG LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "775-423-8024",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506217",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Carl D Robertson and Dr Gregory S Koenig Optometrists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fallon, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.