Jonathon Wayne Robison, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010970A Issued in IN

Practice address

1620 St Joe River Dr
Fort Wayne, IN 46805-0004

Phone

(260) 482-4202

NPI assigned

Aug 29, 2007

Last updated

Aug 29, 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

Medicare fee-for-service enrollment

Enrolled in IN

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

Practice roles

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.

• Dr Timothy Berger

  • Dentist
  • Fort Wayne, IN
  • NPI 1114212461
  NPD (past)

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1255525689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 ST JOE RIVER DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468050004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 ST JOE RIVER DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468050004",
            "telephone_number": "260-482-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBISON",
        "first_name": "JONATHON",
        "middle_name": "WAYNE",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010970A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasha Robinson
• Taylor Tranae Robinson, REGISTERED NURSE
• Thomasina Robinson
• Desiree Robison, COTA/L
• Holly Robison, PHARMD
• Matthew Wayne Robison, DPM
• Alexander Scott Robitaille, DO
• Bryson James Robuck
• Hayley Samantha Robuck, NP
• Daisy Rocha-Brinneman, RBT

• General Practice Dentistry in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.