Kent Mitchell Robertson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

NV 257 Issued in NV

Practice address

409 Murry St
Ely, NV 89301-1948

Phone

(775) 289-2580

Fax

(775) 289-2566

NPI assigned

Aug 1, 2007

Last updated

Nov 26, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kent M Robertson OD Inc

  • Optometrist
  • Ely, NV
  • NPI 1003942707
  Authorized official Same address or phone

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1245420595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 MURRY ST",
            "city": "ELY",
            "state": "NV",
            "postal_code": "893011948",
            "telephone_number": "775-289-2580",
            "fax_number": "775-289-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 MURRY ST",
            "city": "ELY",
            "state": "NV",
            "postal_code": "893011948",
            "telephone_number": "775-289-2580",
            "fax_number": "775-289-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KENT",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "NV 257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002517100",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Marie Rebiejo, LCSW
• Mark A. Rhodes, M.D.
• Ridley's Family Markets, Inc (Ridley's Clinic Pharmacy)
• Ridley's Family Markets, Inc (Ridley's Pharmacy #1154)
• Robertson Optometry LLC
• Tyler Robertson, OD
• Natlie Marina Salinas
• Brigette Elise Saltarelli, CCC-SLP
• Sanderling Renal Services-USA, LLC (Sanderling Dialysis Center - ELY)
• Sarc Nevada LLC

• Optometrist in Ely, NV
• Providers in Ely, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.