Individual provider Active NPI

Ivan L Robinson, FNP-BC

  • Family Nurse Practitioner
  • Mount Rainier, MD
National Provider Identifier
1295830586
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R197474 Issued in MD
Practice address
4201 30TH St
Mount Rainier, MD 20712-1751
Phone
(202) 652-0536
Fax
(202) 536-4369
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R197474 MD Primary

Addresses

Primary practice location

4201 30TH St
Mount Rainier, MD 20712-1751

Mailing address

4201 30TH St
Mt Rainer, MD 20712
Phone (202) 652-0536

Other practice location 1

1902 R NWST
Washington, DC 20009-1015
Phone (202) 652-0536

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R197474MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RHC & Allied Health Associates PastSince Sep 17, 2005 Accepting new patients
Ivan L Robinson and Associates Family PastSince Jan 1, 1990 Accepting new patients
Whitman-Walker Clinic Inc. Past Accepting new patients

Organizations & group practices 3

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295830586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 30TH ST",
            "city": "MT RAINER",
            "state": "MD",
            "postal_code": "20712",
            "telephone_number": "202-652-0536",
            "fax_number": "202-536-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 30TH ST",
            "city": "MOUNT RAINIER",
            "state": "MD",
            "postal_code": "207121751",
            "telephone_number": "202-652-0536",
            "fax_number": "202-536-4369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1902 R NWST",
            "address_purpose": "LOCATION",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200091015",
            "country_code": "US",
            "telephone_number": "202-652-0536",
            "fax_number": "202-536-4369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "IVAN",
        "middle_name": "L",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R197474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Rainier, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.