Individual provider Active NPI

Robert Byram, PHD

  • Marriage & Family Therapist
  • Rock Island, IL
National Provider Identifier
1225474885
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.000435 Issued in IL
Practice address
4703 44TH St
Suite #4
Rock Island, IL 61201-7189
Phone
(309) 788-9581
Fax
(309) 788-9608
NPI assigned
May 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166.000435 IL Primary

Addresses

Primary practice location

4703 44TH St
Suite #4
Rock Island, IL 61201-7189

Mailing address

4703 44TH St
Suite #4
Rock Island, IL 61201-7189
Phone (309) 788-9581

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 Philosophy

State licenses

LicenseStateTypeSpecialty
166.000435ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Youth and Family Solutions 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": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1225474885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4703 44TH ST",
            "address_2": "SUITE #4",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017189",
            "telephone_number": "309-788-9581",
            "fax_number": "309-788-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4703 44TH ST",
            "address_2": "SUITE #4",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017189",
            "telephone_number": "309-788-9581",
            "fax_number": "309-788-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRAM",
        "first_name": "ROBERT",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.000435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.