Individual provider Active NPI

Earl Antonio Robinson

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1205407442
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AN-0024801 Issued in DE
Practice address
5143 W Woodmill Dr
Wilmington, DE 19808-4067
Phone
(302) 999-8426
Fax
(302) 999-8761
NPI assigned
Jul 8, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AN-0024801 DE Primary

Addresses

Primary practice location

5143 W Woodmill Dr
Wilmington, DE 19808-4067

Mailing address

5143 W Woodmill Dr
Wilmington, DE 19808-4067
Phone (302) 999-8426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220704000070 DE Practitioner - Nurse Practitioner 4587044847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Delaware Behavioral Health IncGroup PAC ID 8921227174, 16 clinicians

Practice addresses (Care Compare)

240 N James St
Suite 100 D
Newport, DE 19804-3167
Phone (302) 543-4425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AN-0024801DEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Behavioral Health, Inc. CurrentSince Jun 1, 2022 Accepting new patients

Locations

240 N James St
Ste 100D
Wilmington, DE 19804
Phone (302) 543-4425

240 N James St
Ste 200
Wilmington, DE 19804
Phone (302) 543-4425

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": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1205407442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5143 W WOODMILL DR",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198084067",
            "telephone_number": "302-999-8426",
            "fax_number": "302-999-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5143 W WOODMILL DR",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198084067",
            "telephone_number": "302-999-8426",
            "fax_number": "302-999-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "EARL",
        "middle_name": "ANTONIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "AN-0024801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.