Active NPI
Thomas S Robertson, MD
- Internal Medicine Physician
- Fremont, NE
National Provider Identifier
1306811872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 16800
- Practice address
- 680 E Fremont Medical Park Dr
Suite 100
Fremont, NE 68025-2309 - Phone
- (402) 727-5200
- Fax
- (402) 721-5230
- NPI assigned
- Feb 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 16800 | NE | Primary |
Addresses
Primary practice location
680 E Fremont Medical Park Dr
Suite 100
Fremont, NE 68025-2309
Mailing address
680 E Fremont Medical Park Dr
Suite 100
Fremont, NE 68025-2309
Phone (402) 727-5200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47053664512 | Medicaid | NE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16800 | NE | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fremont Medical Associates - Internal Medicine | Internal Medicine | 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.
-
- Internal Medicine Physician
- Fremont, NE
- NPI 1386627909
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368489600000",
"number": "1306811872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 E FREMONT MEDICAL PARK DR",
"address_2": "SUITE 100",
"city": "FREMONT",
"state": "NE",
"postal_code": "680252309",
"telephone_number": "402-727-5200",
"fax_number": "402-721-5230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 E FREMONT MEDICAL PARK DR",
"address_2": "SUITE 100",
"city": "FREMONT",
"state": "NE",
"postal_code": "680252309",
"telephone_number": "402-727-5200",
"fax_number": "402-721-5230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "THOMAS",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-20",
"last_updated": "2013-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NE",
"license": "16800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47053664512",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fremont, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.